New Dyslipidemia Guidelines Restore LDL Goals and Expand Pharmacist Opportunities

In this episode of the Tell-Tale Heart podcast, host Craig Beavers, PharmD, FACC, FAHA, FCCP, BCCP, BCPS-AQ Cardiology, CACP, is joined by Joseph Saseen, PharmD, BCPS, BCACP, CLS, professor and associate dean for clinical affairs in the Department of Clinical Pharmacy at the University of Colorado Anschutz Skaggs School of Pharmacy and Pharmaceutical Sciences; and Dave Dixon, PharmD, FACC, FAHA, FCCP, FNLA, BCACP, CLS, professor and chair of the Department of Pharmacotherapy and Outcomes Science at Virginia Commonwealth University School of Pharmacy, to discuss the newly released 2026 American College of Cardiology/American Heart Association dyslipidemia guidelines and their implications for pharmacists and patient care.

Saseen and Dixon highlight several key updates in the 2026 guidelines, including the replacement of the pooled cohort equations with the PREVENT (Predicting Risk of Cardiovascular Disease Events) risk calculator, which now estimates 10-year atherosclerotic cardiovascular disease (ASCVD) risk starting at age 30 and offers outputs for total cardiovascular disease, ASCVD, and heart failure risk individually.

The guidelines also restore explicit low-density lipoprotein (LDL) cholesterol goals: less than 70 mg/dL for secondary prevention patients and less than 55 mg/dL for very high-risk patients, along with corresponding non–high-density lipoprotein goals. Coronary artery calcium scoring is now supported by expanded guidance as a personalized risk stratification tool, and lipoprotein(a) screening is a Class I recommendation for all adults. The role of apolipoprotein B as a supplementary lipid marker is also clarified, particularly in patients with metabolic syndrome, type 2 diabetes, or elevated triglycerides.

On the pharmacotherapy side, the guests review the current landscape of nonstatin therapies—including ezetimibe, bempedoic acid, PCSK9 monoclonal antibodies, inclisiran, and the newly approved lerodalcibep (Lerochol; LIB Therapeutics)—emphasizing the growing arsenal available to help patients reach individualized LDL goals. Saseen and Dixon also underscore the critical role pharmacists can play across all practice settings, from initiating statin therapy under collaborative practice agreements to addressing therapeutic inertia and statin intolerance in community pharmacy to supporting prior authorization efforts for nonstatin therapies in managed care.

Join us for an insightful discussion!