Statin Eligibility Rises Under New Guideline

A cross-sectional study published in JAMA estimated that the 2026 American Heart Association/American College of Cardiology/multisociety dyslipidemia guideline substantially expands the US population eligible for statins for the primary prevention of atherosclerotic cardiovascular disease (ASCVD).

Investigators analyzed a nationally representative sample of 4,366 nonpregnant adults aged 30 to 79 years without known ASCVD who participated in the National Health and Nutrition Examination Survey from 2017 through 2023. The sample represented approximately 154.5 million US adults. Researchers compared eligibility for primary prevention statin therapy under the 2026 and 2018 lipid guidelines.

Overall, 17.8% of adults reported currently taking statins, while 5.5% had untreated low-density lipoprotein cholesterol (LDL-C) levels below 70mg/dL. Another 8.6% met statin-eligibility criteria independent of ASCVD risk estimation because of an LDL-C level of at least 190mg/dL, diabetes, or chronic kidney disease. The remaining 68.0% met criteria for using ASCVD risk estimation to guide statin decisions.

Under the 2026 guideline, an estimated 87.5 million adults, representing 56.6% of the target population, were eligible for statin therapy. This included 21.5 million adults, or 13.9% of the population, who were not previously recommended statins. Eligibility varied substantially by age, exceeding 93% among adults aged 70 to 79 years and reaching 85% among those aged 60 to 69 years, compared with 11% among adults aged 30 to 39 years.

Newly eligible adults were generally younger and had a lower estimated 10-year ASCVD risk than those previously eligible for treatment—3.1% compared with 6.1%, respectively. The authors concluded that the guideline substantially expands primary prevention statin eligibility, predominantly among individuals with lower cardiovascular risk.

Source: Anderson TS, Wilson LM, Sussman JB. Implications of the 2026 dyslipidemia guideline for primary prevention statin therapy. JAMA. Published online July 20, 2026. doi:10.1001/jama.2026.11246