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2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA
Guideline on the Management of Dyslipidemia

Updated Multi-Society Guidelines Emphasize Assessment
and Management of LDL‑C1

At Risk of ASCVD (Primary Prevention)

LDL-C Goal <100 mg/dLa

Patient Population (Patients meeting any of the following criteria)

  • Risk calculation with PREVENT-ASCVD <10% for ages 30–79 yearsb,c
  • Severe hypercholesterolemia without FH, ASCVD risk factors, and subclinical atherosclerosis
  • Subclinical atherosclerosis in men ≥40 or women ≥45 years of age with CAC 1–99 AU and <75th percentile for age, sex, and raced
  • Diabetes, age 40–75 years without ASCVD risk factors or diabetes-specific risk modifiersd,e
  • Hypertriglyceridemia, <50 years old with no additional risk enhancers

LDL-C Goal <70 mg/dLf

Patient Population (Patients meeting any of the following criteria)

  • Risk calculation with PREVENT-ASCVD ≥10% for ages 30–79 yearsg,h
  • Severe hypercholesterolemia with FH, ASCVD risk factors, and subclinical atherosclerosis
  • Subclinical atherosclerosis in men ≥40 or women ≥45 years of age with
    • CAC ≥100–299 AU and ≥75th percentile for age, sex, and raceh
    • CAC ≥300–999 AUh,i
  • Diabetes, age 40–75 years with ASCVD risk factors or diabetes-specific risk modifiersh,j
  • Hypertriglyceridemia, age 40–75 years with ≥1 ASCVD risk factorj

LDL-C Goal <55 mg/dLk,l

Patient Population (Patients meeting any of the following criteria)

  • Subclinical coronary atherosclerosis in men ≥40 or women ≥45 years of age with CAC ≥1,000 AUh

With Clinical ASCVD (Secondary Prevention)

LDL-C Goal <70 mg/dLf

Patient Population (Patients meeting any of the following criteria)

  • Not at very high riskh,i
  • Hypertriglyceridemia with clinical ASCVD not at very high riskj

LDL-C Goal <55 mg/dLk

Patient Population (Patients meeting any of the following criteria)

  • At very high riskh,m,n
  • Severe hypercholesterolemia or HeFH with clinical ASCVD
  • Hypertriglyceridemia with clinical ASCVD at very high riskm,n
  • With CKDh

Additional Atherogenic Lipoprotein Goals:

  • aNon–HDL-C <130 mg/dL
  • bIf TG ≥150–499 mg/dL, apoB goal: <90 mg/dL
  • cIn addition to the specified LDL-C goal, ≥30% LDL-C reduction is also recommended
  • dIn addition to the specified LDL-C goal, ≥30–49% LDL-C reduction is also recommended
  • eapoB goal: <90 mg/dL
  • fNon–HDL-C <100 mg/dL
  • gIf TG ≥150–499 mg/dL, apoB goal: <70 mg/dL
  • hIn addition to the specified LDL-C goal, ≥50% LDL-C reduction is also recommended
  • iOptional goal: LDL-C <55 mg/dL, non–HDL-C <85 mg/dL,and consider apoB goal <55 mg/dL
  • japoB goal: <70 mg/dL
  • kNon–HDL-C <85 mg/dL
  • mapoB goal: <55 mg/dL

lCategory added in 2026 Guidelines. nDefined as ≥2 major ASCVD events, or 1 major ASCVD event and ≥2 high-risk conditions. ASCVD events include ACS within the past 12 months, history of myocardial infarction other than ACS, history of ischemic stroke, or symptomatic PAD. High-risk conditions include age ≥65 years, coronary bypass or percutaneous intervention, current smoker, diabetes, history of congestive heart failure, hypertension, or LDL-C ≥100 mg/dL despite conventional management.

AACVPR = American Association of Cardiovascular and Pulmonary Rehabilitation; ABC = Association of Black Cardiologists; ACC = American College of Cardiology; ACPM = American College of Preventive Medicine; ACS = acute coronary syndrome; ADA = American Diabetes Association; AGS = American Geriatrics Society; AHA = American Heart Association; APhA = American Pharmacists Association; apoB = apolipoprotein B; ASCVD = atherosclerotic cardiovascular disease; ASPC = American Society for Preventive Cardiology; AU = Agatston units;
CAC = coronary artery calcium; CKD = chronic kidney disease; FH = familial hypercholesterolemia; HDL-C = high-density lipoprotein cholesterol; HeFH = heterozygous familial hypercholesterolemia; LDL-C = low-density lipoprotein cholesterol; NLA = National Lipid Association;PAD = peripheral artery disease; PCNA = Preventive Cardiovascular Nurses Association; PREVENT = Predicting Risk of cardiovascular disease EVENTs; TG = triglycerides.

Prioritizing LDL-C may help to reduce ASCVD risk for your patients2,4

Discover why

Help your patients get to their guideline-recommended LDL-C goal* to help reduce ASCVD risk1

See more

Get your patients to their LDL-C goal sooner to help mitigate cumulative risk1,2

Learn more

Support your patients by helping them get to their LDL-C goal

Find out how

References: 1. Writing Committee Members; Blumenthal RS, Morris PB, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153:e1-e123.2. doi:10.1161/CIR.0000000000001423 2. Domanski MJ, Tian X, Wu CO, et al. Time Course of LDL Cholesterol Exposure and Cardiovascular Disease Event Risk. J Am Coll Cardiol. 2020;76(13):1507-1516. doi:10.1016/j.jacc.2020.07.059 3.  Ference BA, Braunwald E, Catapano AL. The LDL Cumulative Exposure Hypothesis: Evidence and Practical Applications.  Nat Rev Cardiol. 2024;21(10):701-716. doi:10.1038/s41569-024-01039-5 4. Ference BA, Graham I, Tokgozoglu L, et al. Impact of Lipids on Cardiovascular Health: JACC Health Promotion Series. J Am Coll Cardiol. 2018;72(10):1141-1156. doi:10.1016/j.jacc.2018.06.046