Prevention & lipidsCross-sectional study
Revised lipid-lowering therapy guidelines in a nationally representative sample
- Cross-sectional study
Authors' conclusion
Under the 2026 dyslipidemia guideline, an additional 15.9 million (14.1-17.7) untreated Americans aged 40 to 75 years would be newly identified for treatment consideration. The updated guideline substantially reallocates untreated adults toward consideration for treatment.
Study context
- Population
- Adults aged 40 to 75 years in the National Health and Nutrition Examination Survey (2013–2023) with data suitable for guideline classificationrepresenting 118.9 million U.S. adults, 1,984 already receiving lipid-lowering therapy, 4,134 untreated · already receiving lipid-lowering therapy 1,984 · untreated adults 4,134
- Participants
- 6,118 adults
- Exposure
- classification of U.S. adults under the 2018 and 2026 dyslipidemia guidelines for treatment recommendations
Main finding
As reported in the abstract
Treatment recommendation category among untreated adults
| Group | recommended/indicated | reasonable/favored/selectively-considered | not-routinely-recommended | reasonable |
|---|---|---|---|---|
| 2026 guideline | 1,868 (31.2 million [37.7%]) | 1,154 (27.1 million [32.7%]) | 1,112 (24.6 million [29.7%]) | |
| 2018 guideline | 1,289 (21.2 million [25.6%]) | 1,738 (40.5 million [48.9%]) | 1,107 (21.2 million [25.6%]) |
Observational data: associations, not effects.
Further findings
Reclassification from 2018 to 2026 guideline
- of those in the 2018 reasonable stratum, moved to the 2026 recommended/indicated stratum
- 45.5%
- of the previously not-routinely-recommended, moved to a higher-intensity category
- 39.9%
- All adults recommended/indicated under the 2018 framework remained so under the 2026 framework
Share of the 2026 recommended/indicated stratum accounted for by PREVENT-based pathways
- PREVENT-based pathways
- 33.4%
Original publication
Revised lipid-lowering therapy guidelines in a nationally representative sample. Am Heart J. Published 2 July 2026. doi:10.1016/j.ahj.2026.107524
Summarised from the published abstract; every number is checked against it