Age 30–59 with high lifetime risk, or a major risk enhancer (e.g. premature family history, South Asian ancestry) or elevated Lp(a)? 30-yr risk ≥10%, or LDL-C 160–189, at age 30–59
risk-low-lifetime-highFewer than 5 people have reached this rule so farModerate-intensity statin reasonable; LDL-C <100
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
Your 10-year risk is low, but a moderate-intensity statin is reasonable to discuss — because your 30-year risk is 12%.
A 10-year number is the wrong lens at your age: almost nobody in their thirties or forties clears a 10-year threshold, and waiting until they do means waiting through the decades when the arteries are actually accumulating plaque. The guideline addresses this directly — for adults 30 to 59 with low 10-year risk, treatment is reasonable when 30-year risk reaches 10% or LDL-C sits in the 160-189 range. Target LDL-C below 100 mg/dL (and non-HDL-C below 130).
2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class 2a
Your Lp(a) (70 mg/dL) is elevated. It argues for initiating or intensifying LDL-lowering, on top of whatever your risk category already indicates.
A point of precision worth having: elevated Lp(a) is a reason to lower LDL harder, not a reason to adopt a different numeric target. The guideline uses it to favour starting or intensifying treatment; your actual LDL goal still comes from your risk category, which is stated separately above. There is no approved drug that lowers Lp(a) itself, and the first outcomes trial of one was negative in September 2026 — so LDL, blood pressure, glucose, and smoking are where the leverage is. First-degree relatives may want their own Lp(a) checked once, since it is inherited.
2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class 2a/2b
“Lp(a) measured, moderately high” — an illustrative profile, not a real user.
Asked after: 10-year risk under 3%
Then asks: Coronary artery calcium (CAC) score? (further testing beyond basic labs)
Cited by the recommendations above.
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Runs in lib/engine/lipidPathway.ts as risk-low-lifetime-high.