18 Treat dyslipidemia earlier to reduce lifelong exposure to atherogenic lipoproteins. Health-behavior counseling should start in youth, with early pharmacotherapy considered in youth with familial hypercholesterolemia (FH) and in young adults with LDL-C ≥160 mg/ dL or a strong family history of premature ASCVD. Use the PREVENT equations instead of the Pooled Cohort Equations for 10- and 30-year risk assessment in primary prevention (ages 30–79), applying the “CPR” model: Calculate 10-year ASCVD risk, Personalize the estimate with factors outside PREVENT, and possibly Reclassify with selective coronary artery calcium (CAC) and Reassess treatment. LDL-lowering therapy can be considered at a 10-year PREVENT-ASCVD risk of 3% to <5% (borderline) and should be considered at 5% to <10% (intermediate) after a clinician– patient discussion. LDL-C and non–HDL-C treatment goals are back to guide therapy, with percentage LDL-C reduction remaining a priority and the goal depending on risk level. ApoB testing can be useful to refine risk and guide therapy once LDL-C and non–HDL-C goals are met, particularly with triglycerides ≥150 mg/dL, diabetes, or low achieved LDL-C (<70 mg/dL). 2026 ACC/AHA Multisociety Dyslipidemia Guidelines Top 10 Takeaways Currently, there is no treatment specific for elevated Lp(a), but clinicians can make sure their patients’ LDL-C levels and other modifiable risk factors are well controlled according to the current guideline.4 1 2 3 4 5
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