Primary Prevention of Dyslipidemia: 10 Practice-Changing Takeaways from the 2026 ACC/AHA Multisociety Guideline

Purpose of Review: Dyslipidemia remains a common and treatable risk factor for atherosclerotic cardiovascular disease (ASCVD) in the United States (US) and worldwide. In 2026, the American College of Cardiology (ACC), the American Heart Association (AHA), and other US societies released a new guideline on the management of dyslipidemia. This review summarizes 10 key takeaways in the primary prevention setting from the 2026 multisociety guideline on the evaluation and management of dyslipidemia. Recent Findings: Key takeaways from the new guideline include early evaluation for dyslipidemia and potential genetic dyslipidemias starting in childhood, with subsequent screening every 5 years after age 19. Adult screening for dyslipidemia with Lp(a) at least once in lifetime and selective use of ApoB testing is also recommended. After obtaining lipid measurements, risk assessment is performed using the PREVENT-ASCVD score to calculate 10-year (and 30-year in adults aged 30–59) ASCVD risk. Considering demographic, clinical and laboratory data as well as coronary calcium scoring in addition to the PREVENT-ASCVD risk score allows for shared decision-making regarding initiation of lipid lowering therapy (LLT), primarily with statins. The new guideline also reintroduces treatment goals for LDL-C, non-HDL-C, and apo B in select cases based on risk category for the primary prevention population. Summary: The 2026 ACC/AHA multisociety dyslipidemia guideline incorporates evolving data on dyslipidemia evaluation and management to optimize ASCVD risk. This review describes 10 key highlights from the guideline for the evaluation and management of dyslipidemia in the primary prevention setting.