The latest cholesterol guidelines from the American College Of Cardiology and American Heart Association look at relative risk of heart disease and targeting those patients with the highest risk with highest level of treatment with removal of absolute cholesterol targets. This new guideline is meant to target more high risk patients with intensive cholesterol lowering therapy however it has been controversial in comparison to the European guidelines. For one, it does not look at non-traditional risk assessment tools such as coronary CT for calcium scoring which is being used more often. Furthermore, it does not address residual risk in those who are the very high risk or those who cannot tolerate statin therapy. Lastly, there are new therapeutic options on the horizon such as the PCSK9 inhibitors which are in clinical trials that dramatically reduce cholesterol levels. We can help tailor a treatment plan for you based on your risk profile.