New cholesterol guidelines push for earlier heart disease prevention in 30s

New cholesterol guidelines have been released to help doctors prevent heart disease earlier. The updated advice includes screening people in their 30s and using more precise risk assessments. These changes aim to identify and treat high-risk patients sooner than before.

Doctors should now begin checking cholesterol levels and heart disease risk in adults aged 30 and older. The PREVENT calculator will be used to determine both 10-year and 30-year risks for people between 30 and 79. Risk categories have been updated: low (less than 3%), borderline (3% to less than 5%), intermediate (5% to less than 10%), and high (10% or higher).

For most people without additional risk factors, the target for LDL cholesterol remains below 100 mg/dL. However, those at high risk must aim for levels under 70 mg/dL, while patients with existing heart disease should keep LDL below 55 mg/dL. Statins are now recommended for adults aged 30 and older if their LDL reaches 160 mg/dL or higher.

Further testing is also advised. Everyone should have their lipoprotein(a) levels checked at least once in adulthood. Around 60-90 million US adults are estimated to have elevated levels, which increase their risk of heart disease. Risk thresholds for lipoprotein(a) include low (below 75 nmol/L), high (125 nmol/L or above), and very high (over 430 nmol/L).

For patients with borderline or intermediate 10-year risk, doctors may suggest LDL-lowering treatment. ApoB testing is recommended once LDL goals are met. Additionally, screening for calcium buildup in the coronary arteries is advised for men aged 40 and older and women aged 45 and older if their risk falls into the borderline or intermediate range.

The updated guidelines focus on earlier detection and more personalised treatment. By screening patients in their 30s and using detailed risk assessments, doctors can better target those at higher risk. The goal is to reduce heart disease cases through timely intervention and stricter cholesterol management.