Question 29 of 433
What should my LDL cholesterol be?
The short answer
Lower than you were probably told. The 2026 guideline sets goals again: under 100 if your risk is borderline or intermediate, under 70 if your risk is high or you already have heart disease, and under 55 if you have heart disease and are at very high risk.
For years the guidelines avoided numbers. In March 2026 the American College of Cardiology and the American Heart Association brought targets back, and they moved them down. People at low risk do not get a numeric goal, but they still benefit from a healthy LDL. The evidence is consistent: for LDL, lower is better, and lower for longer is better still. We have not found a level that is too low for the arteries.
If any calcium shows up in your heart arteries on a scan, the goal is under 100 at the very least, and lower as the score rises.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
ROBUST HUMAN TRIALS / GUIDELINE — Risk-selected adults: LDL reduction lowers cardiovascular events; goals depend on risk.Evidence grade (draft mapping)ARobust human trialsPart 3, Q29 · Sources: R4
Sources cited
- R4 Blumenthal RS et al. 2026 ACC/AHA multisociety Guideline on the Management of Dyslipidemia. Journal of the American College of Cardiology. 2026. doi:10.1016/j.jacc.2025.11.016. Link pending verification
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.