Reinstating Targets in Cardiovascular Prevention: Why Guidelines Still Need Clear Goals, With Deepak Bhatt, MD

The American College of Cardiology (ACC) and the American Heart Association (AHA), in conjunction with 9 other medical organizations, have released the 2026 Updated Guidelines for Dyslipidemia and Atherosclerotic Cardiovascular Disease (ASCVD) Management.¹

Published simultaneously on March 13, 2026 in the Journal of the American College of Cardiology and Circulation, the updated document serves as a comprehensive resource for primary care physicians (PCPs) to navigate the complexities of lipid management in a population where 1 in 4 adults presents with elevated low-density lipoprotein cholesterol (LDL-C). The last major comprehensive update regarding blood cholesterol management was published in November 2018.^2,3

In a new interview, Deepak L. Bhatt, MD, MPH, director, Mount Sinai Fuster Heart Hospital, Dr. Valentin Fuster Professor of Cardiovascular Medicine, Icahn School of Medicine, Mount Sinai, reflects on the role of treatment targets and the limitations of guideline development in cardiovascular prevention. He argues that while biological measures like blood pressure and LDL-C exist on a continuum and small numerical differences are clinically trivial, explicit targets remain essential for guiding real-world practice. Targets help clinicians translate evidence into action, titrate therapy appropriately, and provide clear goals for patients.

References:

1. American Heart Association. Published March 13, 2026. Accessed March 13, 2026. https://newsroom.heart.org/news/accaha-issue-updated-guideline-for-managing-lipids-cholesterol
2. American College of Cardiology; American Heart Association. 2026 ACC/AHA updated guidelines for dyslipidemia and ASCVD management. J Am Coll Cardiol. Published online March 13, 2026.
3. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25). doi: https://doi.org/10.1161/cir.0000000000000624