susanbrianmd

Paliwanag

The American Heart Association and American College of Cardiology just released major updates to their cholesterol guidelines, and there are two things everyone should know. First, heart risk screening now starts at age 30 — a full decade earlier than before. Second, the old risk calculator has been replaced by a new tool called PREVENT, which was built on 6.5 million Americans, no longer uses race as an input, and gives you both a 10-year and 30-year estimate of your risk for heart attack, stroke, and heart failure. To use it, you just need a few numbers from a standard blood panel — cholesterol, blood pressure, BMI, and kidney function — and it’s completely free online at the American Heart Association’s website. What the guidelines say to do with your results is straightforward. If your 10-year risk comes back below 3%, focus on lifestyle — diet, exercise, not smoking. If it falls in the gray zone between 3% and 10%, that’s where personalization matters most: your doctor will look at additional “risk enhancers” that the calculator can’t capture, things like your family history, inflammation markers like Lp(a) or hsCRP, conditions like rheumatoid arthritis or lupus, and for women, a history of preeclampsia or early menopause. If your risk is 10% or higher, a statin is generally recommended with a specific LDL target to hit. There are other options if you can’t tolerate or don’t want a statin. The key takeaway is that this is no longer a conversation you wait until your 40s to have — if you’re 30 or older and haven’t had a cardiovascular risk assessment, now is the time to ask your doctor.​​​​​​​​​​​​​​​​ * Slides made with the assistance of AI, but edited by me