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For decades, cholesterol management has largely focused on identifying problems and treating patients after cardiovascular disease has already developed. But according to Michael D. Shapiro, D.O., the inaugural Fred M. Parrish professor of cardiology and molecular medicine at Wake Forest University and a contributor to the new American Heart Association’s 2026 cholesterol guidelines, that approach is changing.
The latest recommendations reflect a growing shift toward prevention, with a stronger emphasis on identifying risk factors earlier in life and tailoring treatment plans to individual patients. Advances in genetics, imaging and blood testing have helped researchers better understand who may be at risk for heart disease long before symptoms appear.
