US cholesterol guidelines call for earlier screening and treatment

Updated US guidance recommends earlier action on unhealthy blood fats to reduce lifetime risks of heart attack, stroke and other cardiovascular disease. The recommendations replace 2018 guidance and consider LDL cholesterol alongside other lipids and lipoproteins linked to artery disease. About one in four US adults is estimated to have high LDL cholesterol.

Screening should begin at ages 9 to 11 if a child has not been tested, or as early as age 2 when there is a family history of serious cardiovascular or cholesterol-related disease. For adults aged 30 to 79, the PREVENT calculator will help estimate 10-year and 30-year risk using cholesterol, blood pressure, age and health habits.

The guidance restores LDL targets of below 100 mg/dL for borderline or intermediate risk, below 70 for high risk and below 55 for very high-risk people with cardiovascular disease. Lifestyle changes remain the first step, but doctors may consider statins and other medicines sooner when levels stay high.