{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:16:14Z","timestamp":1788430574645,"version":"build-2803163510"},"reference-count":53,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The 2026 ACC\/AHA Multisociety Guideline marks a major shift in dyslipidemia management, extending the traditional LDL-C-centered approach to include non-HDL-C, ApoB, lipoprotein(a), triglyceride-rich lipoproteins, inherited lipid disorders, and severe hypertriglyceridemia. The introduction of PREVENT-ASCVD, the renewed use of explicit lipid targets, and the structured integration of risk enhancers and coronary artery calcium support a more individualized approach to cardiovascular prevention. This review critically examines the guideline\u2019s main innovations, with particular attention to the distinction between recommendations supported by cardiovascular outcome evidence and those relying mainly on observational data, surrogate endpoints, or extrapolation. It also compares the US framework with the 2025 ESC\/EAS Focused Update, highlighting growing agreement on LDL-C goals but persistent differences in risk estimation, imaging, biomarkers, and treatment pathways. Finally, we discuss unresolved issues involving implementation, adherence, access, cost, health equity, inclisiran outcomes, and emerging lipoprotein(a)-lowering therapies. The guideline\u2019s impact will depend on translating greater precision into timely, feasible, and equitable care.<\/jats:p>","DOI":"10.3390\/life16091470","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:20:43Z","timestamp":1788427243000},"page":"1470","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The 2026 ACC\/AHA Dyslipidemia Guideline: A Critical and Transatlantic Perspective on Personalized Lipid Management"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-3673","authenticated-orcid":false,"given":"Pierre","family":"Sabouret","sequence":"first","affiliation":[{"name":"Heart Institute and Action Group, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Sorbonne University, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8991-1697","authenticated-orcid":false,"given":"Dario","family":"Mafrica","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2161-3066","authenticated-orcid":false,"given":"Domenico Mario","family":"Giamundo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Policlinico Casilino, 00169 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-8391","authenticated-orcid":false,"given":"Joanna Popiolek","family":"Kalisz","sequence":"additional","affiliation":[{"name":"Clinical Dietetics Unit, Department of Bioanalytics, Medical University of Lublin, Department of Cardiology, Cardinal Wyszynski Hospital in Lublin, ul. Chodzki 7, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3381-605X","authenticated-orcid":false,"given":"Elad","family":"Asher","sequence":"additional","affiliation":[{"name":"Jesselson Integrated Heart Center, The Eisenberg R&D Authority, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1513-8793","authenticated-orcid":false,"given":"Dan","family":"Atar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital Ullev\u00e5l, Kirkeveien 166, 0450 Oslo, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5552-6382","authenticated-orcid":false,"given":"Giuseppe","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico \u201cGaetano Martino\u201d, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1154","DOI":"10.1161\/CIR.0000000000001457","article-title":"2026 ACC\/AHA\/AACVPR\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA guideline on the management of dyslipidemia: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"153","author":"Blumenthal","year":"2026","journal-title":"Circulation"},{"key":"ref_2","first-page":"e1082","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"(2010). Cholesterol Treatment Trialists\u2019 Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: A meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet, 376, 1670\u20131681.","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1016\/j.jacc.2012.09.017","article-title":"Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: A Mendelian randomization analysis","volume":"60","author":"Ference","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1093\/eurheartj\/ehx144","article-title":"Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. 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