Authors
Kapka Miteva, François Mach
Published in
Current opinion in lipidology. Oct 27, 2026. Epub Oct 27, 2026.
Abstract
The global burden of atherosclerotic cardiovascular disease (ASCVD) drives lipid-lowering strategies, now undergoing their biggest transformation since statins. In 2025 and 2026, the two most influential guideline bodies, the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) and the American College of Cardiology/American Heart Association (ACC/AHA), both released updated guidance that reflects evolving clinical evidence. This review provides a detailed, head-to-head examination of their recommendations, highlighting areas of convergence, divergence, and the clinical implications for practitioners on both sides of the Atlantic.
The 2025 Focused Update of the 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias builds incrementally on an established framework, incorporating new trial data within its existing risk-stratified, target-driven model. In contrast, the 2026 ACC/AHA Guideline on the Management of Dyslipidaemia represents a comprehensive rewrite, introducing a novel risk calculator, reinstating explicit LDL-C targets for all risk categories, and endorsing a more flexible, individualized selection of nonstatin therapies.
Both documents embrace the 'lower is better' and 'strike early and strong' paradigms, yet they differ profoundly in how they apply these principles. The review distinguishes the ESC/EAS's structured, stepwise approach from the ACC/AHA's flexible, individualized paradigm (Graphical abstract).
PMID:
42932934
Bibliographic data and abstract were imported from PubMed on 27 Oct 2026.
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