What are your top takeaways for the 2026 ACC/AHA lipid guidelines?

Kudos to the writing committee for this long-awaited update! The 2026 ACC/AHA Dyslipidemia Guideline officially replaces the 2018 standards, reflecting nearly a decade of new clinical evidence.

Here are the 10 biggest shifts every clinician should know:

1. The PREVENT Era is Here: We are moving beyond the old pooled cohort equations. The PREVENT™ risk calculator is now the standard for determining both 10-year and 30-year ASCVD risk.
2. Start Earlier, Aim Lower: There is a renewed emphasis on "primordi...

The new lipid guidelines upgraded the use of CAC and intensified lipid reduction for primary ASCVD event reduction. It remains to be seen if these upgrades will force insurance companies to pay for CAC assessment and pay for newer and more expensive lipid-lowering therapy based on these recommendations. The guideline will definitely increase the use of lipid-lowering therapy for primary ASCVD prevention - polypharmacy, even though it remains unclear if such reductions based on CAC thresholds wil...