Cardiovascular disease remains the leading cause of death worldwide, responsible for millions of heart attacks and strokes each year. One of the main drivers of this risk is dyslipidemia, a condition in which there are unhealthy levels of fats in the blood, such as cholesterol and triglycerides. When these fats build up, they can gradually clog arteries and increase the risk of heart disease.
To help clinicians better prevent and manage these risks, leading international health organisations have released the 2026 Guideline on the Management of Dyslipidemia, a comprehensive set of recommendations developed by the American College of Cardiology (ACC), the American Heart Association (AHA), and several partner organisations. Among the key contributors is Dr Salim Virani, Professor of Cardiology and Population Health, and Vice Provost Research at Aga Khan University.
The guideline updates earlier recommendations and reflects new scientific knowledge about how fats in the blood contribute to heart disease. It highlights research on different types of cholesterol and other particles that carry fats through the body. Some of these, especially low-density lipoprotein (LDL) cholesterol (often called 'bad cholesterol'), can build up along the walls of arteries. Over time, this buildup forms fatty deposits that narrow the arteries and reduce blood flow.
A key message of the new guideline is the importance of detecting and treating unhealthy cholesterol levels early. Acting sooner can reduce the long-term buildup of harmful fats in the arteries, which can lead to blockages and increase the risk of heart attacks and strokes.
The guideline also encourages a more personalised approach to care. Doctors are advised to assess each patient's overall risk of heart disease using established risk calculators. In some cases, they may also check additional substances in the blood, such as lipoprotein(a) and apolipoprotein B, which can provide further clues about a person's risk of developing heart disease.
Healthy lifestyle habits remain the foundation of prevention. A balanced diet, regular physical activity, maintaining a healthy weight, and avoiding tobacco can significantly lower risk. For many people, in addtion to a healthy lifestyle, drugs that reduce cholesterol production in the liver and newer lipid-lowering treatments may also be needed to bring cholesterol to safer levels.
“These guidelines bring together the latest scientific evidence to help clinicians better prevent heart attacks and strokes by managing cholesterol and other lipids more effectively," said Dr Virani. “They emphasise earlier risk assessment, personalised treatment strategies, and the importance of combining lifestyle measures with appropriate medical therapy."
By translating decades of research into practical guidance for clinicians, the guideline aims to help improve prevention and reduce the global burden of cardiovascular disease.
