How Pharmacists Can Apply New Dyslipidemia Guidelines in Practice

In an interview with Pharmacy Times, Joel Marrs, PharmD, MPH, BCACP, BCCP, BCPS, a cardiology ambulatory clinical pharmacist at Cheyenne Regional Medical Group Heart and Vascular Institute and adjoint associate professor at the University of Colorado School of Medicine, discussed key updates from the 2026 American College of Cardiology/American Heart Association Guideline on the Management of Dyslipidemia and the evolving role of pharmacists in cardiovascular risk reduction. Marrs emphasized that pharmacists contributed a critical, practice-based perspective to the guideline development process, particularly in areas such as population health management, risk stratification, and optimization of pharmacotherapy, including newer lipid-lowering agents.

A major update highlighted in the guidelines is the inclusion of apolipoprotein B (ApoB) as a preferred marker in select patient populations. Marrs explained that although low-density lipoprotein cholesterol and non–high-density lipoprotein cholesterol remain primary treatment targets, ApoB can help identify residual cardiovascular risk in patients with diabetes, elevated triglycerides, or established cardiovascular disease who may not appear at goal based on traditional lipid measures. Pharmacists play a key role in educating patients on the purpose of ApoB testing and reinforcing its use as an adjunct to guide more intensive therapy when appropriate.

Marrs also underscored the importance of earlier intervention and improved risk assessment, including adoption of the PREVENT risk calculator from the American Heart Association, which replaces older tools. Pharmacists are well positioned to engage younger patients, promote timely cholesterol screening, and initiate discussions around lifetime cardiovascular risk. Additionally, the guidelines recommend measuring lipoprotein(a) at least once in a patient’s lifetime to further refine risk assessment.

Finally, Marrs noted the growing emphasis on combination therapy, including nonstatin agents alongside statins, to achieve lipid goals. Pharmacists are integral in counseling patients on these therapies, addressing safety and adherence, and ensuring optimal, individualized treatment strategies.