High cholesterol remains one of the most important risk factors for cardiovascular disease, including heart attack and stroke. The new recommendations of the American College of Cardiology and the American Heart Association emphasize the importance of screening even from the age of 30, but also the personalization of treatment.
What is “high” cholesterol and why is it dangerous?
Cholesterol is an essential fat for the body, but in excess, especially in the form of LDL (the so-called “bad cholesterol”), it leads to the deposition of plaque on the arteries. This process – called atherosclerosis – increases the risk of heart disease and stroke.
According to experts, long-term exposure to elevated LDL levels is more dangerous than short-term increases.
What the new guide recommends
The 2026 guidance comes with a proactive approach: it is recommended that risk assessment (screening) starts earlier. From 30 years, instead of 40-50, as it happens now. Physicians are encouraged to use a calculation method called PREVENT (Predicting Risk of Cardiovascular Disease EVENTs), which calculates the 10-year risk for people aged 30 to 79 and the 30-year risk for those aged 30 to 59.
This mechanism takes into account the following factors:
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body mass index
Food and lifestyle
The new recommendations also continue to emphasize the importance of healthy, long-term habits, such as:
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Balanced diet – reducing saturated and trans fats, increasing consumption of soluble fibers (beans, lentils, oats) and fish rich in Omega-3.
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Regular physical activity – a minimum of 150 minutes of moderate exercise per week and strength training two to three times per week.
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Healthy weight – losing weight lowers LDL and triglycerides.
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Quitting smoking and limiting alcohol.
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Adequate sleep – often neglected but important factor for cardiovascular health.
Extensive analyses
The new guidelines recommend additional tests for a complete picture:
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lipoprotein(a)
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apolipoprotein B
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coronary calcium score
These investigations can uncover hidden risks that don’t show up in regular analyses.
Updated recommended values
Risk values have also been updated.
- below 100 mg/dL – low risk
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below 70 mg/dL – high risk or diabetes
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below 55 mg/dL – for patients with a history of heart attack or stroke
Regular blood tests, blood sugar checks and blood pressure monitoring also remain essential.
