2026 ACC/AHA/Multisociety Dyslipidemia Guideline Released

The 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia released today, focused on addressing evaluation, management, and monitoring of individuals living with dyslipidemia, including high blood cholesterol, elevated triglycerides, and elevated lipoprotein(a) [Lp(a)]. This new guideline addresses primordial, primary, and secondary prevention, provides guidance for care of adults and children, restores treatment goals for low-density lipoprotein cholesterol (LDL-C) based on risk, and replaces the 2018 AHA/ACC/Multisociety Guideline on the Management of Blood Cholesterol.

The 2026 ACC/AHA/Multisociety Dyslipidemia Guideline strongly supports dyslipidemia measurement and management through the lifetime, promoting universal lipid testing and management of dyslipidemia through healthy nutrition, lifestyle, and medication for individuals with and without clinical atherosclerotic cardiovascular disease (ASCVD).

“Heart disease is the leading cause of death in the United States and the world. Reversing this trend needs to start before the first heart attack, stroke, or other adverse cardiovascular event. We are very enthusiastic about the guidance provided by the 2026 ACC/AHA/Multisociety Dyslipidemia Guideline for primary and secondary prevention patients, while also promoting the importance of preventing the onset of dyslipidemia, in the reduction of ASCVD risk,” says Kaye-Eileen Willard, MD, FNLA, President of the National Lipid Association.

The Guideline continues to recommend routine lipid testing and provides the following LDL-C treatment goals:

• For individuals living with Clinical ASCVD (secondary prevention):
  • < 55 mg/dL for individuals with clinical ASCVD “at very high-risk”
  • < 70 mg/dL for individuals with clinical ASCVD “not at very high-risk.”
• For individuals not living with Clinical ASCVD (primary prevention):
  • Individuals with LDL-C ≥ 190 mg/dL:
    • < 100 mg/dL, and
    • < 70 mg/dL for individuals with heterozygous familial hypercholesterolemia, one or more ASCVD risk factors, or subclinical atherosclerosis.
  • Individuals with LDL-C between 70-189 mg/dL:
    • < 100 mg/dL for individuals at low, borderline, or intermediate PREVENT-ASCVD risk
    • < 70 mg/dL for individuals at high risk as calculated by the PREVENT-ASCVD risk equations.
• For individuals with subclinical atherosclerosis:
  • < 100 mg/dL for individuals with a coronary artery calcium (CAC) score of 1-99 AU and < 75th percentile score for age, sex, or race
  • < 70 mg/dL for individuals with a CAC score ≥ 100-299 AU or CAC ≥ 75th percentile for age, sex, or race
  • < 55 mg/dL for individuals with a CAC score ≥ 1000 AU

“It is great to see the 2026 ACC/AHA/Multisociety Dyslipidemia Guideline restore LDL-C treatment goals,” says Christie M. Ballantyne, MD, FNLA, Immediate Past President of the NLA, who further stated that, “The new guideline extends additional support that ‘lower [LDL-C] for longer is better’.”

The ACC/AHA/Multisociety Dyslipidemia Guideline also recommends universal screening of adults for elevated Lp(a), a well-recognized causal factor of ASCVD, independent of LDL-C, along with special considerations for testing children < 18 years of age.

The 2026 ACC/AHA/Multisociety Dyslipidemia Guideline provides express considerations for referral to a lipid specialist, particularly as the complexity of management of dyslipidemias continues to increase as more patients are identified with challenging lipid disorders, treatment goals for lipid disorders get lower, and additional therapies with different mechanisms of action are available.

“Lipid management is best accomplished through team-based care,” says Anne Carol Goldberg, MD, MNLA, NLA Chief Science Officer and Past-President of the American Board of Clinical Lipidology. While lipid management generally occurs in the primary care, internal medicine, and family practice setting, lipid specialists are available to support our colleagues in managing individuals with ASCVD or at high-risk for ASCVD, individuals with genetic disorders and complex medication requirements, and individuals who are pregnant, considering pregnancy, and breastfeeding. We also support the inclusion of considerations for referral to a registered dietitian nutritionist.”

The NLA is the leading organization for education and resources on complex lipid topics and rare and complex lipid disorders. Stay tuned for additional resources from the NLA to enhance the science and practice of lipidology and promote optimal cardiometabolic health.

Read the Guidelines