Updated guidelines for managing high cholesterol have just been released by the American College of Cardiology and the American Heart Association, replacing the earlier ones issued in 2018, reports Science Alert.
“Shifting the paradigm toward proactive prevention strategies earlier in life can change the trajectory of cardiovascular disease and lead to better health outcomes for people decades later,” said cardiologist Seth Martin, from the Johns Hopkins Ciccarone Centre for the Prevention of Cardiovascular Disease.
New sections include advice about early screenings for those with a family history of heart disease or high cholesterol, with proposals to make risk estimations more personalised to individual patients as well and to start medication earlier in certain cases.
The updated guidelines also recommend clinicians switch to using PREVENT (Predicting Risk of Cardiovascular Disease Events) scores to calculate a person’s risk of cardiovascular disease. As of August 2025, PREVENT is also recommended for assessing people with high blood pressure.
In addition, the guidelines have updated cholesterol thresholds for doctors and other health professionals to refer to when assessing patients.
It’s estimated that as many as one in four adults in the United States have elevated LDL cholesterol, which significantly contributes to the risk of atherosclerotic cardiovascular disease (ASCVD) – the leading cause of death worldwide.
The better news is that around 80% of cardiovascular disease is thought to be preventable. The authors said the health burden doesn’t have to be anywhere near as high as it is – and the new recommendations should help with that.
Alongside the updated guidelines, the experts have also published The ABCs of Cardiovascular Disease Prevention, a paper reviewing the latest evidence on factors contributing to heart disease risk, including diabetes, alcohol intake, and body fat levels.
In their conclusions, they note that recommendations will need to evolve as we better understand the risks to heart health posed by vaping and cannabis. Refining the clinical definition of obesity will also impact our understanding of heart health risks.
The guidelines have been published in the Journal of the American College of Cardiology.
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