LDL-C management simplified: The National Lipid Association lipid simplified series

Atherosclerotic heart disease is a leading cause of morbidity and mortality, with the magnitude of atherosclerotic cardiovascular disease (ASCVD) event reduction being proportional to the degree of low-density lipoprotein cholesterol (LDL-C) lowering. The 2026 American College of Cardiology/American Heart Association/Multisociety Guideline on the Management of Dyslipidemia highlights the need to achieve LDL-C levels that are "lower for longer" with treatment targeted to individual ASCVD risk. Current risk estimators, biomarkers, and imaging tools have allowed for the improved discrimination of ASCVD risk to select those who benefit most and guide the intensity of treatment. With the combination of optimal lifestyle therapy and an armamentarium of lipid-lowering agents, achieving optimal levels is attainable and essential to cardiovascular health. Referrals to lipid specialists should be considered for complex care to increase access to advanced therapeutics and manage complex cases. Toward that goal, lipid panel testing should be done regularly in adults to evaluate ASCVD risk and to monitor for effectiveness and adherence to LDL-C-lowering treatment. The following manuscript is intended to serve as a "simplified" guide to the management of LDL-C in clinical practice.