New Cholesterol Guidelines Recommend Lipoprotein(a) Test

The updated guidelines aim to expand the tools doctors use to assess cardiovascular risk.

Mar. 13, 2026 at 8:56pm

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The American Heart Association and the American College of Cardiology have released new guidelines for managing cholesterol, which now recommend a one-time lipoprotein(a) blood test for all adults. This test can help assess a person's lifetime risk for cardiovascular disease. The guidelines also call for wider use of coronary calcium scoring and a risk assessment tool called PREVENT to guide decisions about starting cholesterol-lowering medication, even for those at relatively low risk.

Why it matters

Cardiovascular disease is the leading cause of death in the U.S., and these new guidelines aim to help doctors and patients take a more proactive and comprehensive approach to preventing heart attacks and strokes. The lipoprotein(a) test in particular can identify an inherited risk factor that was previously underutilized.

The details

The updated guidelines recommend that all adults be tested once for lipoprotein(a), a genetic risk marker for heart disease. This simple blood test can give a more complete picture of someone's cardiovascular risk. The guidelines also call for wider use of coronary calcium scoring, a non-invasive scan that measures plaque buildup, as well as a risk assessment tool called PREVENT to help guide decisions about starting cholesterol-lowering medication. Under the new framework, statins could be considered even for patients with relatively low risk if their overall lifetime risk profile supports it.

  • The new guidelines were released on March 13, 2026.

The players

American Heart Association

A nonprofit organization focused on cardiovascular health and research.

American College of Cardiology

A medical professional society and leading authority on cardiovascular care.

Dr. Roger Blumenthal

A cardiologist at Johns Hopkins in Baltimore who chaired the guideline writing committee.

Dr. Steven Nissen

A preventive cardiologist at Cleveland Clinic who says the new guidelines will result in more people being treated earlier for high cholesterol.

Dr. Leslie Cho

A preventive cardiologist at Cleveland Clinic who emphasizes the importance of diet and exercise as the "cornerstone of good cardiac prevention."

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What they’re saying

“We know 80% or more of cardiovascular disease is preventable and elevated LDL cholesterol, sometimes referred to as 'bad' cholesterol, is a major part of that risk.”

— Dr. Roger Blumenthal, Cardiologist, Johns Hopkins (Statement)

“Measuring additional biomarkers, like lipoprotein(a), can give a more complete picture of someone's cardiovascular risk and help inform decisions about whether lipid-lowering therapy is needed sooner rather than later.”

— Dr. Roger Blumenthal, Cardiologist, Johns Hopkins (Statement)

“That's a sea change. A person's lifetime risk is what counts.”

— Dr. Steven Nissen, Preventive Cardiologist, Cleveland Clinic (NPR)

“These new guidelines will result in more people being treated earlier.”

— Dr. Steven Nissen, Preventive Cardiologist, Cleveland Clinic (NPR)

“The cornerstone of good cardiac prevention is diet and exercise.”

— Dr. Leslie Cho, Preventive Cardiologist, Cleveland Clinic (NPR)

What’s next

The new guidelines are published in the journal Circulation and in JACC, the Journal of the American College of Cardiology.

The takeaway

These updated cholesterol guidelines represent a shift towards more proactive and comprehensive prevention of heart disease, with the lipoprotein(a) test emerging as a key new tool to assess lifetime risk. By identifying high-risk individuals earlier, doctors can intervene with lifestyle changes and medications to potentially reduce the burden of cardiovascular disease.