Welcome — and thank you for being here. Whether you are reading this

for yourself, a spouse, a parent, or a child, you are doing something

that matters: investing time in understanding your health before a

crisis happens. That is what preventive medicine is all about, and it

is what we are here for.

In March 2026, the American College of Cardiology and the American

Heart Association — along with nine other major medical organizations

— released the first updated national cholesterol guidelines since

2018. These changes affect nearly every adult in the United States.

Here is what you need to know.

WHY CHOLESTEROL MATTERS AS MUCH AS WE SAY IT DOES

Heart disease is still the number one cause of death in the United

States. And roughly 1 in 4 American adults has elevated LDL

cholesterol — the “bad” kind that slowly builds up inside artery

walls over decades.

Think of it like mineral deposits building up in a pipe. A small

amount in your 30s may not cause symptoms. But it does not go away on

its own. By your 50s or 60s, that buildup has been collecting for

decades. A heart attack or stroke often feels sudden to the person

experiencing it — but the process behind it started years, sometimes

decades, earlier. The good news: 80% or more of cardiovascular

disease is preventable. Cholesterol is one of the biggest levers we

have to pull.

WHAT IS NEW IN THE 2026 GUIDELINES

1. MORE CLEAR CHOLESTEROL TARGETS

The new guidelines restore specific LDL (“bad cholesterol”) goals

based on your individual risk level:

• Low to borderline risk:    LDL goal < 100 mg/dL
• Intermediate or high risk: LDL goal < 70 mg/dL
• Prior heart attack/stroke: LDL goal < 55 mg/dL

The bottom line: lower is better, and the higher your risk, the

lower we want your number.

2. A SMARTER RISK CALCULATOR

For over a decade, doctors used an older tool called the Pooled

Cohort Equations to estimate 10-year heart attack and stroke risk.

The problem? It consistently overestimated risk — sometimes by

40-50%. Some patients were being recommended medication they may

not have needed, while others with real risk were missed.

The new guidelines now use the PREVENT score (Predicting Risk of

Cardiovascular Disease Events). PREVENT was built on more modern,

more diverse patient data. It removes race as a variable — since

race is a social construct, not a biological risk factor — and

accounts for things like kidney health and neighborhood-level

social stressors that genuinely affect heart disease risk. It can

also estimate your 30-year risk, not just 10-year — which matters

a great deal for younger patients who still have time to change

their trajectory.

3. LP(a): THE CHOLESTEROL NUMBER YOU HAVE PROBABLY NOT HEARD OF

Your standard cholesterol panel does not tell the whole story.

There is a particle called lipoprotein(a) — or Lp(a), pronounced

“L-P-little-a” — that can significantly raise your risk of heart

disease, stroke, and aortic stenosis, independent of your regular LDL.

You can have a perfectly normal cholesterol panel and still carry

a dangerously elevated Lp(a).

Lp(a) is largely determined by your genetics, not your diet or

lifestyle. The new guidelines now recommend that every adult be

tested for Lp(a) at least once in their lifetime.

We offer Lp(a) testing at our clinic for under $10 out of pocket.

It is a single blood test, most people only need it once, and it

could genuinely change how we assess your heart risk — especially

if you have a family history of heart disease or have had a cardiac

event despite “normal” cholesterol.

4. START EARLIER

The new guidelines push for earlier action. High cholesterol begins

affecting your arteries in adolescence, not just middle age.

Treatment may now be considered for adults as young as 30 who have

high long-term risk — and earlier screening is recommended for

children with a family history of heart disease. If a parent or

sibling had a heart attack before age 55 (men) or 65 (women),

please make sure we know that.

LIFESTYLE: IT MATTERS MORE THAN YOU MIGHT THINK

The guidelines make one thing crystal clear: lifestyle is the

foundation. Before any conversation about medication, we talk about

habits — because the evidence behind them is real.

A heart-healthy diet (think a plant-predominant diet that we advocate — plenty

of vegetables, fruits, whole grains, legumes) can

lower LDL by 10-30% on its own for many people. Regular physical

activity — even 30 minutes of brisk walking most days — raises your

good cholesterol, lowers triglycerides, and protects your heart.

Quitting smoking, improving sleep, and managing weight all play

meaningful roles too.

We will be honest with you: swapping the sausage, egg, and cheese

biscuit for oats and blueberries most mornings is not a punishment —

it is one of the most powerful things you can do for your future.

Small, consistent choices compound over time the same way plaque

does. The difference is which direction you want things going.

Now — what if lifestyle changes are not enough? That is NOT a personal

failure. Genetics plays a huge role in how your body produces and

processes cholesterol. Some people do everything right and still need

medication to reach a safe number. That is okay, and that is what we

are here to help with. But here is the important part: even if you do

need medication, your lifestyle habits are still doing critical work.

They reduce blood pressure, control blood sugar, lower inflammation,

support healthy weight, improve sleep, and reduce your risk of

diabetes, cancer, dementia, and depression. A medication handles the

cholesterol number. Your daily habits shape everything else.

YOUR ACTION ITEMS

Here is what we would ask you to think about and bring up at your

next appointment:

GET YOUR LABS DONE — If you have not had a cholesterol panel in

the past year, let’s get one scheduled. Routine lipid testing is

the only way to know where you stand. You cannot manage what you

do not measure.

ASK ABOUT LP(a) — If you have never been tested for Lp(a), ask us

about adding it to your next lab order. It is under $10, you only

need it once, and it could tell us something important about your

risk that your regular cholesterol panel never would.

CONTROL WHAT YOU CAN — Blood pressure, blood sugar, weight,
smoking, sleep — these are all part of your cardiovascular risk

picture. If any of these are not where they should be, let’s make

a plan together. One well-controlled risk factor can make a

significant difference in your overall trajectory.

MAKE A REAL COMMITMENT TO LIFESTYLE — This does not mean

perfection. It means most days, most meals, moving in the right

direction. More vegetables, less processed food. More movement,

less sitting. Better sleep. Less stress where possible. These

choices add up — and they matter whether or not you are on

medication.

We are honored to be your partners in this. Heart disease is largely

preventable, and we have better tools now than ever before to catch

risk early and address it personally. If you have questions about how

the new guidelines apply to your specific situation, please bring them

to your next visit. No question is too small when it comes to your

heart.

To your health —

Dr. Kaitlyn Newman at Verity Medicine

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