Objective

Overview

Evaluation and Diagnosis

Management

Complications of Management

Design and created by Guideline Central in participation with the American College of Cardiology and American Heart Association.

Management of Dyslipidemia

American College of Cardiology

American Heart Association

Publication Date: May 4, 2026

Definitions

Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A cluster of health problems that often occur together, including excess belly fat, blood sugar issues (such as prediabetes or type 2 diabetes), unhealthy cholesterol levels, high blood pressure and sometimes kidney disease.
Clinical Atherosclerotic Cardiovascular Disease (ASCVD): A history of serious heart or blood vessel problems, such as heart attack, stroke, chest pain (angina) or poor circulation in the legs. "Very high risk" applies to those who have had multiple major events or one major event along with additional risk factors like older age, diabetes, high blood pressure or smoking.
Lifestyle Management: Changes to daily habits that support heart health, including eating well, staying physically active, avoiding tobacco and nicotine products, getting enough sleep, managing stress and maintaining a healthy weight.
Subclinical Atherosclerosis: Plaque buildup in the arteries that has already started but has not yet caused any symptoms, chest pain or cardiovascular events.
Triglycerides: A type of fat (lipid) found in the blood. They come from food and are also made by the body from extra calories, especially from carbohydrates, fats and alcohol.
Cholesterol: A waxy substance the body uses to build cells and to make hormones. The body needs some cholesterol, but having too much in the blood increases the risk of heart disease and stroke.
LDL-C (Low-Density Lipoprotein Cholesterol): The "bad" cholesterol. High levels lead to plaque buildup in arteries, increasing the risk of heart attack and stroke.
Apolipoprotein B (ApoB) is a protein found on “bad” cholesterol particles. Each harmful cholesterol particle has one ApoB, so measuring ApoB gives a count of how many of these particles are in the blood. This can give a better estimate of heart disease risk than LDL cholesterol alone.
Non-HDL-C (Non-High-Density Lipoprotein Cholesterol): The total cholesterol minus HDL ("good") cholesterol. It includes all “bad” cholesterol particles that can contribute to plaque buildup in the arteries.
HDL (High-Density Lipoprotein): The "good" cholesterol because it acts as a scavenger in the bloodstream. It carries excess cholesterol from other parts of the body back to the liver, which breaks it down and removes it. Higher levels of HDL are associated with lower risks of heart disease and stroke.
Lipoproteins are particles made of protein and fat (lipids) that transport cholesterol and triglycerides through the bloodstream. They are essential for moving fats, which cannot dissolve in the blood on their own. Key types include HDL, LDL and lipoprotein(a), a genetic form linked to increased heart disease and stroke risk.
Familial hypercholesterolemia (FH): An inherited condition in which people are born with very high LDL cholesterol levels. If not identified and treated early in life, people with FH are at increased risk for premature heart disease and stroke.
Homozygous familial hypercholesterolemia (HoFH): Occurs when an individual inherits two FH gene variants, one from each parent. The disorder is characterized by extremely high, life-threatening levels of LDL cholesterol from birth, leading to significant premature cardiovascular morbidity and mortality if left untreated.
A coronary artery calcium score is a measurement from a specialized heart CT scan that calculates the amount of calcified plaque buildup in the arteries.
Children: For the purposes of this patient summary, children are defined as anyone 18 years old or younger.

Source Citation

Blumenthal, RS, Morris, PB, Gaudino, M, Johnson, HM, Anderson, TS, Bittner, VA, Blankstein, R, Brewer, LC, Cho, L, de Ferranti, SD, Gianos, E, Gluckman, TJ, Gradney, K, Isiadinso, I, Lloyd-Jones, DM, Marrs, JC, Martin, SS, McLain, KH, Mehta, LS, Mora, S, Mulugeta, WM, Natarajan, P, Navar, AM, Orringer, CE, Polonsky, TS, Reynolds, HR, Saseen, JJ, Shapiro, MD, Soffer, DE, Tynes, SA, Villavaso, CD, Virani, SS, Wilkins, JT. 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. [published online ahead of print March 13, 2026]. J Am Coll Cardiol. doi: 10.1016/j.jacc.2025.11.016.

Copublished in Circulation. doi: 10.1161/CIR.0000000000001423

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Management of Dyslipidemia

Objective

Overview

Definitions

Evaluation and Diagnosis

Screening in Children and Adults

Measurement of Cholesterol and Triglycerides

Measurement of Apolipoprotein B

Measurement of Lipoprotein (a)

Monitoring and Follow-Up

Management

Lifestyle Management

Lifelong Prevention: Starting in Childhood

Dietary Approaches in Dyslipidemia

Managing High LDL-C Through Diet

Managing High Triglycerides Through Lifestyle

Weight Management

Physical Activity

Dietary Supplements

When to See a Registered Dietitian Nutritionist

Medical Management

Reproductive Health and Heart Risk

Imaging to Assess Heart Disease Risk

Primary Prevention for Adults at Risk

Low 10-Year ASCVD Risk

Borderline and Intermediate 10-Year ASCVD Risk

High 10-Year ASCVD Risk

Special Considerations

Severe High Cholesterol

Risk Assessment in Heterozygous Familial Hypercholesterolemia

Genetic Testing for Familial Hypercholesterolemia

Severe High Cholesterol - General

Homozygous Familial Hypercholesterolemia

Diabetes Without Known ASCVD

Secondary ASCVD Prevention

Not at Very High Risk

At Very High Risk

Heart Failure Due to Heart Disease (Reduced Ejection Fraction)

Managing Early Plaque in Heart Arteries

Patient Considerations

Children and Adolescents

Young Adults

Older Adults

Managing Cholesterol During Pregnancy and Breastfeeding

Adults With Heart Failure

Adults With Chronic Kidney Disease

Persons Living With Human Immunodeficiency Virus

Adults With Cancer or History of Cancer

Management of High Triglycerides

Approach to Elevated Lp(a)

Managing Statin-Related Muscle Symptoms

Complications of Management

Medication Safety and Side Effects

Drug Interactions With Statins

Source Citation

Disclaimer