Archive · 21 Aug 2026
US Cholesterol Guidelines Call for Earlier, More Personalized Screening
The new advice says people should start checking their cholesterol earlier.
Most children should be tested between ages 9 and 11.
Some children may need testing as early as age 2 if heart disease or high cholesterol runs strongly in their family.
Doctors should not look only at one cholesterol number.
They should also consider a person’s overall chance of having heart disease or a stroke.
The safer LDL cholesterol target is lower for people at greater risk.
Adults should have a special cholesterol-related particle called Lp(a) checked at least once.
Eating well, exercising, maintaining a healthy weight and avoiding tobacco are still important.
Medicines may be used when lifestyle changes are not enough.
Children should receive cholesterol testing at ages 9 to 11, or as early as age 2 with a strong family history.
The recommendations restore LDL cholesterol targets tailored to cardiovascular risk, ranging from below 100 to below 55 mg/dL.
Doctors are encouraged to use updated PREVENT-ASCVD equations to estimate 10-year and 30-year heart disease risk.
Adults should have their lipoprotein(a), or Lp(a), level measured at least once, with ApoB testing considered for selected patients.
Healthy eating, exercise, weight management and avoiding tobacco remain central, with medication added when lifestyle changes are insufficient.
- Who
- US doctors, children, adults and people at elevated cardiovascular risk.
- What
- Updated cholesterol recommendations call for earlier screening, risk-based LDL targets and broader cardiovascular assessment.
- When
- The article does not specify when the updated recommendations were issued.
- Where
- The recommendations apply in the United States.
- Why
- To identify elevated cholesterol earlier and tailor treatment to individual risk, potentially helping prevent later heart attacks and strokes.
- Child screening
- Routine cholesterol testing is recommended between ages 9 and 11.
- Early testing
- Testing may begin at age 2 for children with a strong family history of high cholesterol or early cardiovascular disease.
- LDL target: borderline or intermediate risk
- Below 100 mg/dL.
- LDL target: high risk
- Below 70 mg/dL.
- LDL target: very high risk
- Below 55 mg/dL for people with existing cardiovascular disease who are at very high risk.
- Risk assessment
- Updated PREVENT-ASCVD equations estimate 10-year and 30-year cardiovascular disease risk.
- Additional testing
- Adults should have Lp(a) measured at least once; ApoB may be useful for selected patients.