What should my LDL cholesterol target be?

Your LDL result and your treatment goal are different things. The result is a measurement. The goal depends on your clinical risk and the guideline framework used.

No heart attack does not automatically mean low risk

Established vascular disease, diabetes, kidney disease, inherited lipid disorders and other factors can alter risk assessment. Tell your clinician about your history rather than treating the report in isolation.

Understand the framework

The 2026 ACC/AHA guidance describes LDL-C goals below 100 mg/dL for borderline/intermediate primary-prevention risk and below 70 mg/dL for high risk; very-high-risk ASCVD has a goal below 55 mg/dL. The ESC/EAS framework uses its own risk categories and goals. Similar-looking numbers should not be mixed across frameworks without explaining which risk category applies.

Questions worth asking

Which risk category am I in? Which guideline framework are we using? What is my LDL goal? Do non-HDL cholesterol, ApoB or Lp(a) add useful information in my case? When should the response to the plan be reviewed?

Avoid comparing your target with a friend's

Two people with the same LDL can need different prevention discussions. Do not change prescribed treatment based on another person's number or an isolated social post. Ask for an explanation of your own plan.

Sources

ACC/AHA lipid guideline

ESC/EAS 2025 dyslipidaemia update

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