2026 ACC/AHA/Multisociety Dyslipidemia Guideline Reframes Lipid Management and Targets

The 2026 ACC/AHA/Multisociety guideline introduces lower treatment goals, formal risk equations, and mandates Lp(a) assessment for dyslipidemia pharmacists.

2026 ACC/AHA DyslipidemiaAmerican College of CardiologyAHAlipid-lowering therapystatinsPCSK9 inhibitorsbempedoic acidinclisiranevinacumabolezarsenLp(a)apoB Dyslipidemia

Authors: Blumenthal RS, Morris PB, Gaudino M, Johnson HM, Anderson TS, Bittner VA, Blankstein R, Brewer LC, Cho L, de Ferranti SD, Gianos E, Gluckman TJ, Gradney KF, Isiadinso I, Lloyd-Jones DM, Marrs JC, Martin SS, McLain KH, Mehta LS, Mora S, Mulugeta WM, Natarajan P, Navar AM, Orringer CE, Polonsky TS, Reynolds HR, Saseen JJ, Shapiro MD, Soffer DE, Tynes SA, Villavaso CD, Virani SS, Wilkins JT

Citation: Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2026;87(19):2624-2757. doi:10.1016/j.jacc.2025.11.016

Article Links: PubMed · Journal / DOI

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Practice-changing Impact 3/5

Fundamental changes in risk calculation, lipid targets, and mandatory Lp(a)/apoB assessment will reshape day-to-day lipid management for pharmacists.

Evidence Grade: Moderate

The guideline bases recommendations on multiple large RCTs, meta-analyses, and robust observational studies but introduces new agents and populations with moderate-to-strong certainty.

What's New / Changed vs. Prior Version

This guideline supersedes the 2018 version, introducing significant updates including the use of PCSK9 inhibitors, inclisiran, and bempedoic acid. Novel recommendations involve polygenic risk scores and coronary artery calcium scoring, with a focus on LDL-C targets and new patient management strategies.

Key Recommendations

High-intensity statin therapy is recommended for individuals with very high ASCVD risk (Class I, Level of Evidence A). Non-statin therapies such as PCSK9 inhibitors and inclisiran are recommended for secondary prevention in select individuals not at goal with statins (Class IIa, Level of Evidence B). New guidance on utilizing coronary artery calcium scoring to refine risk assessment in intermediate-risk individuals (Class IIa, Level of Evidence B).

Practice Impact for Pharmacists

Integration of PCSK9 inhibitors and inclisiran in patients inadequately managed with statins.
Incorporation of new risk assessment tools like polygenic risk scores.
Adjustment of therapy based on coronary artery calcium scoring for tailored risk management strategies.

Implementation Considerations

Cost and access to non-statin therapies may limit widespread adoption. Additional training on using polygenic risk scores and calcium scoring is necessary. EHR systems will require updates to support new risk assessment and management strategies.

Controversies / Dissenting Opinions

None noted

Editor's Note

All recommendations and class/level assignments were directly extracted from guideline tables and structured content. If institutional protocols do not yet reflect these changes, transitional practice pathways may require explicit development. Verification is needed for local test availability of Lp(a) and apoB.

Full text source: Drive Reprocess – 2026 ACC/AHA/Multisociety Dyslipidemia Guideline