<div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1755411396" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{11}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">New American College of Cardiology/American Heart Association</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>(</span><span class="NormalTextRun SCXW244575277 BCX0">ACC/AHA</span><span class="NormalTextRun SCXW244575277 BCX0">)</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>dyslipidemia<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">support</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>the use of<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">low-density lipoprotein<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">(</span><span class="NormalTextRun SCXW244575277 BCX0">LDL</span><span class="NormalTextRun SCXW244575277 BCX0">)</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>targets and earlier, broader risk assessment </span><span class="NormalTextRun SCXW244575277 BCX0">to<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">prevent atherosclerotic cardiovascular disease (ASCVD).</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1504989923" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{13}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0">,</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>published in the</span></span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">Journal of the American College of Cardiology</span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">,<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">recommend</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">risk-based<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">LDL-</span><span class="NormalTextRun SCXW244575277 BCX0">cholesterol (LDL-C) and non</span><span class="NormalTextRun SCXW244575277 BCX0">-</span><span class="NormalTextRun SCXW244575277 BCX0">high-density lipoprotein cholesterol (non</span><span class="NormalTextRun SCXW244575277 BCX0">-</span><span class="NormalTextRun SCXW244575277 BCX0">HDL-C) targets across primary prevention, diabetes, severe hypercholesterolemia, subclinical<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">atherosclerosis</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>and secondary prevention</span><span class="NormalTextRun SCXW244575277 BCX0">.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1544225642" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{15}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The authors specify<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">an LDL-C goal of <</span><span class="NormalTextRun SCXW244575277 BCX0">55 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL and non–HDL-C goal of <</span><span class="NormalTextRun SCXW244575277 BCX0">85 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL for many patients with established ASCVD at<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">very high</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>risk.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="162645404" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{17}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">“LDL-C and non–high-density lipoprotein cholesterol (HDL-C) treatment goals are back to guide<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">lipid-lowering therapy</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>(</span><span class="NormalTextRun SCXW244575277 BCX0">LLT</span><span class="NormalTextRun SCXW244575277 BCX0">)</span><span class="NormalTextRun SCXW244575277 BCX0">.<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">Percentage reduction in LDL-C<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">remains</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>a priority for all individuals as well, with goal for % reduction depending on the level of ASCVD risk</span><span class="NormalTextRun SCXW244575277 BCX0">,</span><span class="NormalTextRun SCXW244575277 BCX0">”</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">wrote the w</span><span class="NormalTextRun SCXW244575277 BCX0">riting</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>c</span><span class="NormalTextRun SCXW244575277 BCX0">ommittee</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>m</span><span class="NormalTextRun SCXW244575277 BCX0">embers</span><span class="NormalTextRun SCXW244575277 BCX0">, led by<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">Roger S. Blumenthal, MD,<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">from<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">Johns Hopkins Medicine</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>in</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>Baltimore.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1769602663" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{19}"><strong><span class="NormalTextRun SCXW244575277 BCX0">Widening the focus</span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" lang="EN-US" paraid="1804100175" paraeid="{cb2813b4-f96a-4378-a536-45f257e55645}{232}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The 2026<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0">, which w</span><span class="NormalTextRun SCXW244575277 BCX0">ere</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>d</span><span class="NormalTextRun SCXW244575277 BCX0">eveloped in<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">c</span><span class="NormalTextRun SCXW244575277 BCX0">ollaboration<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">w</span><span class="NormalTextRun SCXW244575277 BCX0">ith the American Association of Cardiovascular and</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">Pulmonary Rehabilitation, American College of Preventive</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">Medicine</span><span class="NormalTextRun SCXW244575277 BCX0">,</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">American Society for Preventive<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">Cardiology</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">and other professional organizations</span><span class="NormalTextRun SCXW244575277 BCX0">,<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">replaces the 2018 blood cholesterol<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">with a broader focus on the evaluation,<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">management</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>and monitoring of dyslipidemias.<span> </span></span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":6,"335551620":6,"335559685":0,"335559737":0,"335559738":0,"335559739":160,"335559740":259}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="726241415" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{23}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guidance</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">also<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">covers elevated blood cholesterol,<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">hypertriglyceridemia</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>and elevated lipoprotein(a) [</span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a)], reflecting an expanded view of lipid-related cardiovascular risk.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1852273841" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{25}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">One notable change is the terminology adopted, with the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>moving from “blood cholesterol” to “dyslipidemia” to reflect the role of atherogenic lipoproteins beyond LDL particles alone. These include triglyceride-rich remnant particles and<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a), as well as apolipoprotein B (</span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">apoB</span><span class="NormalTextRun SCXW244575277 BCX0">)-containing particles more broadly.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="639033846" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{27}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">also<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">pl</span><span class="NormalTextRun SCXW244575277 BCX0">ace a</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>stronger emphasis on lifetime risk, rather than only short-term cardiovascular risk in middle age. This shift affects how<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">clinicians are advised to</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>think about screening, lifestyle<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">counseling</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>and treatment decisions in younger patients.<span> </span></span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="625853298" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{29}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">“Treat dyslipidemia earlier to reduce<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">lifelong</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>risk of prolonged exposure to atherogenic lipoproteins</span><span class="NormalTextRun SCXW244575277 BCX0">,” wrote the committee</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>members.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="363674544" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{31}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">“</span><span class="NormalTextRun SCXW244575277 BCX0">Health behavior counseling to support lifestyle optimization should start in youth, with early consideration of pharmacotherapy in youth with familial hypercholesterolemia (FH) and in young adulthood in individuals with low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL or a strong family history of ASCVD.”</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="212838433" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{33}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">Identifying</span><span class="NormalTextRun SCXW244575277 BCX0"> ASCVD risk</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="372478691" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{35}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>recommend</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>lipid screening in adults beginning at age 19 years and at least every five years thereafter to<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">identify</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>treatable ASCVD risk. More frequent screening is<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">also<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">recommended for people with<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">additional</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>ASCVD risk factors.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1500507689" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{37}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">In children aged 9 to 11 years who ha</span><span class="NormalTextRun SCXW244575277 BCX0">ve</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>not previously been tested, the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>recommend</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>lipid screening to<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">identify</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>FH and other significant lipid disorders. The authors state that early exposure to hypercholesterolemia in childhood<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">wa</span><span class="NormalTextRun SCXW244575277 BCX0">s associated with prevalent and incident subclinical atherosclerosis and increased ASCVD risk in middle age.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="371199421" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{39}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">For adults at low 10-year ASCVD risk, the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>recommend</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">health<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">behavior</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>counseling when LDL-C is <</span><span class="NormalTextRun SCXW244575277 BCX0">160 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL and 30-year risk is <10% in those aged 30 to 59 years. However, moderate-intensity statin therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s considered reasonable for adults with low 10-year<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">risk</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>but LDL-C of 160 to<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">189 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL, or 30-year ASCVD risk ≥10%, to reduce cumulative exposure to atherogenic lipoproteins.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1691292233" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{45}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">In adults with borderline 10-year ASCVD risk, moderate-intensity statin therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s reasonable when a decision is made to<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">initiate</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>treatment. For intermediate-risk adults, at least moderate-intensity statin therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s recommended, with high-intensity statin therapy beneficial for those at the higher end of the intermediate-risk range.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1561915737" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{48}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">For adults at high 10-year ASCVD risk, the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>recommend</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>high-intensity statin therapy to achieve an LDL-C reduction of ≥50%. It<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">is</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>also<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">considered<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">reasonable to treat to an LDL-C goal of <</span><span class="NormalTextRun SCXW244575277 BCX0">70 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL and non–HDL-C goal of <</span><span class="NormalTextRun SCXW244575277 BCX0">100 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL. If these goals<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">a</span><span class="NormalTextRun SCXW244575277 BCX0">re not achieved on maximally tolerated statin therapy, the addition of ezetimibe<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s reasonable.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="980736738" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{50}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">Defined </span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">apoB</span><span class="NormalTextRun SCXW244575277 BCX0"> role </span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="695174321" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{52}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>g</span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">ve</span><span> </span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">apoB</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>testing a more defined role in selected patients. In adults receiving lipid-lowering therapy, particularly those with ASCVD, cardiovascular-kidney-metabolic (CKM) syndrome, type 2<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">diabetes</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>or elevated triglycerides,<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">apoB</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>measurement<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s reasonable to guide decisions about further treatment intensification once LDL-C and/or non–HDL-C goals<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">are</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>achieved.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="639378268" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{54}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The authors state that<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">apoB</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>may help<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">identify</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>residual lipoprotein-related risk that c</span><span class="NormalTextRun SCXW244575277 BCX0">ould</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>be underestimated by standard lipid testing. This<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s particularly relevant in patients with elevated triglycerides,<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">diabetes</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>or<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">low achieved</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>LDL-C.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="893821091" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{56}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a) testing<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s also given a stronger recommendation</span><span class="NormalTextRun SCXW244575277 BCX0">,</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>with t</span><span class="NormalTextRun SCXW244575277 BCX0">he<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>recommend</span><span class="NormalTextRun SCXW244575277 BCX0">ing</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>that<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a) be measured at least once in all adults for ASCVD risk assessment.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1436039606" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{58}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">Elevated<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a), defined as ≥125 nmol/L or ≥</span><span class="NormalTextRun SCXW244575277 BCX0">50 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL,<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s considered a risk-enhancing factor. The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">state</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>that<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a) levels ≥125 nmol/L<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">are</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>associated with about a 1.4-fold increased ASCVD<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">risk, while values ≥250 nmol/L or ≥</span><span class="NormalTextRun SCXW244575277 BCX0">100 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">are</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>associated with an estimated risk increase of at least twofold.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="942512987" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{60}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW244575277 BCX0"><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a)</span> <span class="NormalTextRun SCXW244575277 BCX0">measurement</span></span></strong><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="169744002" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{62}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">“Lipoprotein(a) [</span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a)] should be measured at least once to<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">identify</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>those individuals at<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">higher</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>risk of ASCVD. It is<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">considered as</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>a risk-enhancing factor at levels ≥125 nmol/L (</span><span class="NormalTextRun SCXW244575277 BCX0">50 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL), which is associated with about a 1.4-fold increased ASCVD risk, and values ≥250 nmol/L (</span><span class="NormalTextRun SCXW244575277 BCX0">100 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL) are associated with ≥2-fold higher estimated risk</span><span class="NormalTextRun SCXW244575277 BCX0">,” the authors wrote.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1332346105" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{64}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">In people with elevated<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a), the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>recommend</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">optimal</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>early control of modifiable cardiovascular risk factors. In patients with clinical ASCVD and elevated<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Lp</span><span class="NormalTextRun SCXW244575277 BCX0">(a) who ha</span><span class="NormalTextRun SCXW244575277 BCX0">ve</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>not achieved LDL-C and non–HDL-C goals on maximally tolerated statin therapy, the addition of a proprotein convertase subtilisin/</span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">kexin</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>type 9 monoclonal antibody (PCSK9<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">mAb</span><span class="NormalTextRun SCXW244575277 BCX0">) with proven cardiovascular benefit<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s recommended.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="807062957" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{66}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>also expand</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>the role of<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">coronary artery<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">calcium (</span><span class="NormalTextRun SCXW244575277 BCX0">CAC</span><span class="NormalTextRun SCXW244575277 BCX0">)</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>scoring in primary prevention. In adults at intermediate risk and selected adults at borderline risk, CAC scoring should be used if the decision about lipid-lowering therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">remain</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">uncertain.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="566371771" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{68}"><strong><span class="NormalTextRun SCXW244575277 BCX0">CAC-based treatment targets</span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1170456496" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{74}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">For adults with subclinical coronary atherosclerosis, the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>provide</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>CAC-based treatment targets. Adults with CAC scores of 100 to 299 Agatston units or at least the 75th percentile should receive LDL-C–lowering therapy, with statins considered first line, to achieve LDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">70 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL and non–HDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">100 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="414799684" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{76}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">For CAC scores of 300 to 999 Agatston units, LDL-C–lowering therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s recommended to achieve at least a 50% LDL-C reduction and LDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">70 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL. For CAC scores ≥1000 Agatston units, the<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">recommend</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>a more aggressive LDL-C goal of <</span><span class="NormalTextRun SCXW244575277 BCX0">55 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL and non–HDL-C goal of <</span><span class="NormalTextRun SCXW244575277 BCX0">85 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1429120661" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{78}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">In adults with severe hypercholesterolemia and clinical ASCVD, the addition of ezetimibe, a PCSK9<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">mAb</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>or bempedoic acid<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s recommended to achieve LDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">55 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL and non–HDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">85 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL.<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Inclisiran</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s also considered reasonable in adults with severe hypercholesterolemia, with or without clinical ASCVD, and LDL-C ≥</span><span class="NormalTextRun SCXW244575277 BCX0">100 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL despite maximally tolerated statin therapy with or without ezetimibe.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1599505002" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{82}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">For adults with diabetes aged 40 to 75 years and no clinical ASCVD, moderate-intensity statin therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">indicated</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>to achieve a 30% to 49% LDL-C reduction and LDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">100 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL. In those with multiple<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">ASCVD risk factors, high-intensity statin therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s reasonable to achieve at least a 50% LDL-C reduction and LDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">70 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="302293905" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{84}"><span class="NormalTextRun SCXW244575277 BCX0"><strong>Secondary prevention advice</strong> </span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="349571234" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{86}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">Secondary prevention recommendations<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">are</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>also more<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">target based</span><span class="NormalTextRun SCXW244575277 BCX0">. In adults with clinical ASCVD who<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">a</span><span class="NormalTextRun SCXW244575277 BCX0">re not at<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">very high</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>risk, high-intensity statin therapy should be<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">initiated</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>to achieve at least a 50% LDL-C reduction and LDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">70 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1122501859" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{89}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">For adults with clinical ASCVD at<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">very high</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>risk, ezetimibe and/or a PCSK9<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">mAb</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>should be added to maximally tolerated statin therapy to achieve LDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">55 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL and non–HDL-C <</span><span class="NormalTextRun SCXW244575277 BCX0">85 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL. Bempedoic acid and<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">inclisiran</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">a</span><span class="NormalTextRun SCXW244575277 BCX0">re included as options in selected patients based on treatment response, access,<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">tolerability</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>and dosing preference.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1100386422" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{91}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">Hypertriglyceridemia<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s addressed both as a cardiovascular risk factor and as a pancreatitis risk factor. In patients with persistently elevated triglycerides, statin therapy<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">remain</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>the foundation of pharmacotherapy to reduce ASCVD risk. Treatment aimed at preventing pancreatitis may also include triglyceride-lowering therapies, especially when triglycerides are ≥</span><span class="NormalTextRun SCXW244575277 BCX0">1000 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="362054225" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{93}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">In adults with familial chylomicronemia syndrome and fasting triglycerides ≥</span><span class="NormalTextRun SCXW244575277 BCX0">1000 mg</span><span class="NormalTextRun SCXW244575277 BCX0">/dL,<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">olezarsen</span><span class="NormalTextRun SCXW244575277 BCX0">, an apolipoprotein C-III inhibitor,<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">i</span><span class="NormalTextRun SCXW244575277 BCX0">s recommended as an adjunct to diet to lower triglycerides and reduce pancreatitis risk.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="2046923660" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{95}"><strong><span class="NormalTextRun SCXW244575277 BCX0">Dietary supplement use</span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="922950218" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{97}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>discourage</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>the use of dietary supplements for lipid lowering</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">sta</span><span class="NormalTextRun SCXW244575277 BCX0">ting</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>that, in individuals with dyslipidemia, dietary supplements<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">a</span><span class="NormalTextRun SCXW244575277 BCX0">re not recommended to lower LDL-C or triglycerides because of limited and inconsistent data and/or limited benefit in lipid lowering and ASCVD risk reduction.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="542669189" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{99}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">The<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">guideline</span><span class="NormalTextRun SCXW244575277 BCX0">s</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>conclude by acknowledging that future progress will depend not only on better risk markers and treatment options, but on improving how evidence is translated into long-term care. The authors<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">identify</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>implementation, adherence, therapeutic inertia, risk<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW244575277 BCX0">communication</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>and shared decision-making as priorities for future research.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="2074211839" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{101}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">“Ongoing studies of how clinicians can best interact with patients to arrive at informed decisions are vital. This is particularly important because LDL-C–lowering therapy is meant to be a long-term or lifetime therapy</span><span class="NormalTextRun SCXW244575277 BCX0">,” the experts wrote.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" lang="EN-US" paraid="922876555" paraeid="{cc32a609-bf7e-476b-bbc4-ba17deb15b6f}{56}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">“</span><span class="NormalTextRun SCXW244575277 BCX0">Refinement of individualized communication with patients about treatment options may have major implications for long-term treatment adherence and patient outcomes by fostering trust, buy-in, and engagement.”</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1597356532" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{103}"><strong><span class="NormalTextRun SCXW244575277 BCX0">Source:</span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" paraid="1743441062" paraeid="{6c17a315-9c36-44fb-9f49-e8c73dc54c76}{105}"><span data-contrast="none" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">Blumenthal RS, Morris PB, Gaudino M, et al. 2026</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/</span><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">APhA</span><span class="NormalTextRun SCXW244575277 BCX0">/ASPC/NLA/PCNA<span> </span></span><span class="NormalTextRun SCXW244575277 BCX0">Guideline</span><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>on the Management of Dyslipidemia.<span> </span></span></span><span data-contrast="none" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0"><em>J Am</em> <em>Coll </em></span><em><span class="NormalTextRun SpellingErrorV2Themed SCXW244575277 BCX0">Cardiol</span></em><span class="NormalTextRun SCXW244575277 BCX0">.</span></span><span data-contrast="none" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0"><span> </span>2026</span><span> </span><span class="NormalTextRun SCXW244575277 BCX0">(</span><span class="NormalTextRun SCXW244575277 BCX0">Article in Press</span><span class="NormalTextRun SCXW244575277 BCX0">)</span><span class="NormalTextRun SCXW244575277 BCX0">.</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW244575277 BCX0"> <p class="Paragraph SCXW244575277 BCX0" lang="EN-US" paraid="818778529" paraeid="{20e64043-2931-48fc-9b22-40fc04b9cc21}{164}"><strong><span data-contrast="none" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW244575277 BCX0"><span class="NormalTextRun SCXW244575277 BCX0">Image Credit: Tom</span><span class="NormalTextRun SCXW244575277 BCX0"> – stock.adobe.com</span></span><span class="EOP SCXW244575277 BCX0" data-ccp-props="{}"> </span></strong></p> </div>