Lipid Guidelines: Four Major Concerns John M. Mandrola, MD May 14, 2026 + + + + +

https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim?ecd=mkm_ret_260517_mscpmrk_cardio_lipids_mai_etid8346155&uac=148436CN&impID=8346155 People disagree about clinical practice guidelines. Proponents hold that more stringent recommendations reduce practice variation. Others, like me, worry that medicine is too complex to create robotic treatment algorithms. Yet no matter where you stand on the idea of guidelines, not controversial is that a guideline document should be pragmatic, grounded in evidence, and as free from conflicts as possible. Lp(a) Levels Associated With Highest Cardiovascular Risk Identified Brian Owens https://www.medscape.com/viewarticle/lp-levels-associated-highest-cardiovascular-risk-identified-2026a1000dr9?ecd=mkm_ret_260517_mscpmrk_cardio_lipids_mai_etid8346155&uac=148436CN&impID=8346155 April 29, 2026 Elevated levels of lipoprotein(a) above 175 nmol/L is associated with increased cardiovascular risk, especially among patients with existing heart disease, and warrants aggressive treatment to reduce risk, according to a new study. “For the first time, we can quantify the specific level of Lp(a) that puts patients at a significantly higher risk of major cardiovascular events, especially stroke and death,” said Subhash Banerjee, MD, an interventional cardiologist at Baylor Scott & White in Dallas. Apolipoprotein B Outperforms Traditional Targets for Lipid-Lowering Therapy Lois Anzelowitz Levine, MA https://www.medscape.com/viewarticle/apolipoprotein-b-outperforms-traditional-targets-lipid-2026a1000d6f?ecd=mkm_ret_260517_mscpmrk_cardio_lipids_mai_etid8346155&uac=148436CN&impID=8346155 April 24, 2026 LDL cholesterol still drives treatment decisions in assessing heart disease risk, but a new study suggests apolipoprotein B (apoB), which measures artery-clogging particles, could do a better job. In a computer simulation involving 250,000 statin-eligible individuals, published in JAMA, study authors found that apoB-guided treatment improved outcomes and remained highly cost-effective. However, it also led to more intensive therapy, raising questions about whether better apoB is a better target or simply more treatment driving the benefit. New Lipid Guidelines: A User’s Guide Michelle L. O'Donoghue, MD, MPH; Roger S. Blumenthal, MD https://www.medscape.com/viewarticle/new-lipid-guidelines-users-guide-2026a10009so?ecd=mkm_ret_260517_mscpmrk_cardio_lipids_mai_etid8346155&uac=148436CN&impID=8346155 Michelle L. O'Donoghue, MD, MPH: Hi. This is Dr Michelle O'Donoghue, reporting for Medscape. One of the most important topics that we've been discussing is the 2026 ACC/AHA dyslipidemia guidelines, so it's a real pleasure to be joined today by the chair of the writing committee for the dyslipidemia guidelines, Dr Roger Blumenthal, who's the director of the preventive cardiology center at Johns Hopkins. Welcome, Roger. Does Ez-PAVE Support ‘Lower Is Better’ for LDL-C? John M. Mandrola, MD One of the many controversial recommendations from the US 2026 lipid guidelines was to lower the low-density lipoprotein cholesterol (LDL-C) target from < 70 mg/dL to < 55 mg/dL for patients with established atherosclerotic cardiovascular disease (ASCVD). April 08, 2026 https://www.medscape.com/viewarticle/does-ez-pave-support-lower-better-ldl-c-2026a1000akx?ecd=mkm_ret_260517_mscpmrk_cardio_lipids_mai_etid8346155&uac=148436CN&impID=8346155 April 02, 2026