Specialists are moving away from the long-standing step-by-step method of treating lipid disorders and instead favour starting patients on combination therapy straight away, according to a report by AD HOC NEWS published on 21 October 2026. The recommendation is aimed at bringing harmful cholesterol levels into the therapeutic target range without delay, so that the overall cardiovascular risk of affected patients falls faster and more effectively.
The shift is driven largely by strict targets for low-density lipoprotein cholesterol (LDL-C). For people at very high cardiovascular risk — for instance, those who have already had a heart attack or a stroke — the required LDL-C level is below 1.8 mmol/L. At the same time, the value must come down by more than 50% from the patient's own starting level. Where the risk is judged to be at the highest level, an even tighter goal of under 1.4 mmol/L applies.
Why it matters
Cardiovascular disease remains a leading cause of death worldwide, and the gap between what guidelines demand and what patients actually achieve is wide. The experts' argument is not only about slowing ongoing damage to blood vessels. According to the reports cited by AD HOC NEWS, cutting LDL-C by more than half can actively shrink existing atherosclerotic plaques. Reducing those vessel changes is seen as a decisive lever for preventing further cardiovascular events.
The timing of treatment also matters. Prof. Dr. Ingo Eitel of Lübeck, speaking at a press conference, said that the earlier a patient acts, the more years of life may potentially be gained. Cumulative LDL-C exposure across a person's lifetime is a causal risk factor, he explained, which means that deliberately lowering LDL-C can measurably reduce cardiovascular risk at any point.
Screening and clearer lab reports
To catch dangerous lipid disorders early, the experts call for wider preventive testing. They recommend at least one lipid test from the age of 30. They also want laboratory findings to be more transparent in everyday practice: lab reports should in future state the patient's individual risk category — such as high or very high — directly, so that treating physicians can place the results therapeutically without delay.
The scale of the care gap is illustrated by figures from China cited in the reporting. There, the prevalence of dyslipidemia is close to 40%, yet awareness of the condition stands at roughly 11.7%. Only about 10.1% of those affected are receiving treatment, and the condition is considered controlled in just about 4.8%. Cardiovascular disease is the most common cause of death in the country, accounting for around two in five deaths.
What to watch
Whether health systems and payers adjust their treatment pathways to match the experts' push for upfront combination therapy — and whether risk categories start appearing as standard on laboratory reports — will be the signals to follow in the coming months.
