New Cholesterol Guidelines: What They Mean For Your Health

New national guidelines from leading medical organizations can help you and your provider better understand your cholesterol and take steps to prevent heart attack and stroke.

These guidelines are based on large research studies that include thousands of people. They were published in March 2026 in JACC, the flagship journal of the American College of Cardiology, and Circulation, the flagship journal of the American Heart Association.

Key Takeaways: New Cholesterol Guidelines

• Experts now recommend lower LDL target numbers than in the past, especially if you are at higher risk.
• Cholesterol checks and risk assessments can begin earlier in adulthood to catch problems sooner.
• You need heart care that is based on your full health picture, including your age, lifestyle, family history and other conditions.
• If you take steps now, you can reduce your risk of heart disease over your lifetime.

Guidelines Set New Target Numbers For LDL Cholesterol

Cholesterol is a waxy substance found in your blood and cells. There are two main types.

• LDL (low-density lipoprotein) is the “bad cholesterol.” It can build up in your arteries and increase your risk of heart attack and stroke. About 1 in 4 U.S. adults has high LDL cholesterol.
• HDL (high-density lipoprotein) is the “good cholesterol.” It helps remove extra cholesterol from your bloodstream.

A primary care provider can order a simple cholesterol test. Most adults should be tested every four to six years, or more often if they have risk factors.

The main change in the new guidelines is lower target numbers for LDL cholesterol.

• Many adults should aim for LDL under 100
• Higher-risk individuals may need to be under 70
• People with heart disease may need to be closer to 55

“For many patients, especially those with heart disease or prior procedures, it’s not enough to look at whether a number is flagged as normal,” said Asad J. Torabi, MD, an interventional cardiologist with Franciscan Health. “The latest guidelines recommend aiming for lower LDL levels than before because our goal is to prevent another heart attack or stroke and keep patients as safe as possible.”

Prevention Starts Earlier Than You May Think

About 80 percent of heart disease is preventable, and high LDL cholesterol is a major part of that risk.

The new guidelines put a stronger focus on prevention at younger ages. In the past, many people did not think about cholesterol until their 40s or later. Now, providers look at heart health earlier to help prevent problems before they begin.

“I think it’s very reasonable to have a one-time cholesterol check as a very young adult, just to get a baseline and make sure everything looks okay,” Dr. Torabi said. “We see patients younger and younger with risk factors, especially if there is a family history of high cholesterol.”

This matters because high cholesterol often has no symptoms. The sooner you make changes, the greater the impact on your long-term health.

The guidelines encourage providers to use a newer cardiovascular disease risk calculator called PREVENT for people with elevated LDL cholesterol. It estimates your risk for a heart attack or stroke using information from a routine checkup, such as cholesterol levels, blood pressure, age and lifestyle habits, along with other health conditions to give a more personalized picture of your heart health.

Healthy Habits Are The First Step

Once you understand your risk, the next step is to take action to lower it. Many people decide they want to embrace lifestyle changes before they consider medication. This includes:

• A heart-healthy diet
• Regular physical activity
• Weight loss to achieve a healthy weight
• Not smoking

“If a patient tells me their diet could be better and they want to try something like the Mediterranean diet, I let them give it a shot,” Dr. Torabi said. “I say, ‘All right — let’s pretend you’re in Greece. Let’s get out the almonds, the plant-based protein and the olive oil, and cut down on the red meat. Then let’s look at your numbers in a few months and see how much it helps.”

Medication Is One Of Many Tools

If lifestyle changes aren’t enough, your provider may recommend medication to help lower your risk.

Statins are a type of medicine that lowers LDL cholesterol. They slow down how much cholesterol your liver makes and help your body remove it more effectively. Some people do very well on statins. Some people may have side effects, such as muscle aches.

“If someone tries two different statins and the side effects don’t improve, we have other options,” Dr. Torabi said. “For example, there are injectable medications that work differently than statins and don’t cause muscle aches. We have a lot of tools and can tailor treatment to help patients reach their goal of lower LDL and a lower risk of stroke or heart attack.”

You Need A Personalized Care Plan

Cholesterol is only one part of your overall health. The new guidelines encourage providers to look at your full health picture, including:

• Your age
• Blood pressure
• Family history
• Other conditions, such as diabetes

For example, people with diabetes may need stricter cholesterol goals. If you manage your blood sugar well, your cholesterol levels may improve.

“I always remind patients not to focus on just one number in isolation,” Dr. Torabi said. “Everything is connected, and we look at the full picture to decide what makes the most sense for you.”

Ask About Your Cholesterol Numbers And Your Personal Risk

Do you want to focus on your heart health, but don’t know where to begin?

Start with a primary care visit. Ask your provider about your cholesterol numbers and what they mean for you. Together, you can create a plan to help protect your heart health now and in the future.

“I like making decisions with my patients,” Dr. Torabi said. “It’s not about telling someone what they have to do. It’s about working together to find a plan that makes sense and that they feel comfortable following.”

Concerned About Your Heart? Don’t Wait.

Talk with your provider if you experience chest pain, shortness of breath, fatigue, dizziness, swelling in the abdomen or legs, or an irregular heartbeat. Your provider may recommend you see a specialist to learn more.

Find a provider or request an appointment online.

Reminder: Call 911 if you experience sudden chest pain, discomfort or pressure — especially if it spreads to your arm, neck, jaw or back — along with shortness of breath, sweating or nausea. These symptoms may signal a heart attack or other cardiac emergency.