From new biomarkers to emerging lipid-lowering therapies. What do the new2026 American dyslipidemia guidelines tell us?

Abstract

Atherosclerotic cardiovascular disease is the leading cause of death. The new ACC/AHA dyslipidemia guidelines, endorsed by a total of eleven societies, provide the latest evidence and recommendations for evaluating and treating dyslipidemia.The guidelines highlight the importance of early promotion of cardiovascular health by a healthy lifestyle, early lipid screening, and precision-based primary and secondary prevention.Key takeaways include the early screening for dyslipidemia in
childhood for identifying hereditary dyslipidemias,one-time screening for lipoprotein(a),and increased testing of apolipoprotein B in selected individuals.For improved decision making in individuals with borderline and intermediate risk, the guidelines recommend coronary artery calcium scoring
and evaluating other high-risk conditions,such as family and reproductive history,cardiovascular-kidney-metabolic syndrome, and others.There is greater emphasis on treatment goals, not only for LDL but also for non-HDL cholesterol and apolipoprotein B. Statins remain the cornerstone of treatment,in addition to broader use of other evidence-based non-statin therapies in individualizing discussions between healthcare providers and patients.