
The new 2026 guidelines, which lower LDL targets and start primary prevention at younger ages while adding Lp(a) testing, reinforce the finding that millions may need earlier cholesterol-lowering medications. That intensifies the existing tension between expanding preventive therapy for more people and efforts to reassess or deprescribe some long-standing medications. The guidance makes questions about screening, costs, and equitable access more urgent for clinicians and health systems.
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