A new American Heart Association/American College of Cardiology/multisociety dyslipidemia guideline could expand eligibility for primary prevention statin therapy to an estimated 21.5 million additional U.S. adults, according to a study published July 20 in JAMA.
The 2026 guideline, released in March, retires and replaces the 2018 AHA/ACC/multisociety cholesterol guideline, swapping the decades-old Pooled Cohort Equations for a newer risk calculator, PREVENT, which drops race as an input, adds kidney function, and is built on a much larger and more contemporary dataset. The guideline also added a 30-year ASCVD risk pathway alongside the traditional 10-year estimate and lowered the risk thresholds at which statins can be considered.
Here are four things to know from the study:
- Researchers analyzed data from 4,366 National Health and Nutrition Examination Survey participants representing 154.5 million U.S. adults ages 30 to 79 years without known atherosclerotic cardiovascular disease.
- Researchers estimated that 87.5 million U.S. adults, or 56.6% of adults ages 30 to 79 years without known atherosclerotic cardiovascular disease, would be eligible for primary prevention statin therapy under the 2026 guideline.
- Older adults account for much of the expansion. More than 93% of adults ages 70 to 79 years and 85% of adults ages 60 to 69 years would be eligible for statins, compared with 11% of adults ages 30 to 39 years.
- The newly eligible population is lower risk. Newly statin-eligible adults had a mean estimated 10-year ASCVD risk of 3.1%, compared with 6.1% among adults previously eligible for statin therapy.
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