# New cholesterol guidelines personalize your heart risk > Updated 2026 guidelines shift cholesterol treatment toward earlier screening and personalized plans based on your unique risk factors. - Title: New cholesterol guidelines personalize your heart risk - Summary: Updated 2026 guidelines shift cholesterol treatment toward earlier screening and personalized plans based on your unique risk factors. Doctors now use… - Keywords: cholesterol, dyslipidemia, cardiovascular disease, american heart association, american college of cardiology, ldl cholesterol, hdl cholesterol, statins, personalized medicine, heart health, prevention, 2026 guidelines - Source: The Conversation — https://theconversation.com/cholesterol-control-gets-personalized-a-cardiologist-explains-how-new-guidelines-tailor-treatment-to-your-unique-risk-profile-279080 - Author: William Cornwell - Read time: 3 min - Topics: cholesterol, dyslipidemia, cardiovascular disease, american heart association, american college of cardiology, ldl cholesterol, hdl cholesterol, statins, personalized medicine, heart health, prevention, 2026 guidelines ## A quarter of Americans have high cholesterol Dyslipidemia, or high cholesterol and fatty acids in the blood, affects at least 25% of Americans. Uncontrolled levels increase risk of atherosclerotic cardiovascular disease, which can lead to heart attack and stroke. ## New guidelines arrived in March 2026 The American Heart Association and American College of Cardiology released updated cholesterol treatment guidelines, the first major update since 2018. They incorporate findings from new studies on how to treat and prevent dyslipidemia more effectively. ## Start treatment earlier and more aggressively The 2026 update emphasizes treating high cholesterol earlier in life and more aggressively. Research shows a strong relationship between how long cholesterol stays high and lifetime cardiovascular disease risk. ## New blood tests reveal hidden risk Beyond standard LDL and HDL tests, guidelines now emphasize lipoprotein A (LpA) and apolipoprotein B (ApoB). These newer markers can better predict cardiovascular disease risk, especially for patients with diabetes or metabolic syndrome. ## ApoB counts plaque particles, not just mass ApoB measures the number of plaque-forming particles in your blood, while LDL measures their mass. For some patients, ApoB more accurately predicts cardiovascular disease risk than LDL alone. > ApoB measures the number of plaque particles in the blood. ## LpA is a stickier, riskier cholesterol Lipoprotein A is similar to LDL but has an extra protein that makes it stickier and more likely to cause artery blockages. The guidelines recommend checking LpA once in all adults to determine lifetime cardiovascular disease risk. ## Calcium scans show plaque buildup directly Coronary artery calcium scores from CT scans directly measure calcium deposits in heart arteries. More calcium means higher cardiovascular disease risk, and guidelines now recommend using these scores to personalize treatment. ## Use the PREVENT calculator for your risk The PREVENT-ASCVD online calculator uses body mass index, blood pressure, diabetes history, kidney function, and smoking status to estimate your 10-year and 30-year cardiovascular disease risk. This helps doctors classify you as low, intermediate, or high risk. ## Statins remain first-line treatment Statins like atorvastatin and rosuvastatin remain the standard medication for cholesterol management. Newer medication classes can be added if statins alone don't work or cause side effects. ## Screen children and young adults early Children ages 9 to 11 should have cholesterol checked. Adults starting at age 19 should be screened every five years. Those at increased risk may start medications as early as age 30. ## Diet and exercise remain the foundation Healthy lifestyle choices are essential. Guidelines recommend 150 minutes per week of moderate exercise or 75 minutes of vigorous exercise, plus two days of resistance training. Diet should limit sugar, refined carbs, saturated fats, and alcohol. ## Lose 5 to 10 percent of body weight For overweight or obese patients, losing 5 to 10 percent of total body weight helps reduce cardiovascular disease risk. Combined with exercise and diet changes, modest weight loss makes a real difference. ## Key takeaway Doctors now use multiple blood tests, risk calculators, and imaging to create personalized cholesterol treatment plans starting earlier in life.