Cholesterol Treatment: Earlier Prevention, PCSK9 Escalation, and Statin Decisions

New guidance expands statin eligibility and promotes earlier screening and stepwise escalation to ezetimibe or PCSK9 therapy. Recent evidence supports intensive LDL lowering and plaque improvement in high-risk patients, while a limited trial raises the possibility of individualized statin discontinuation after age 75 without prior ASCVD. Dyslipidemia management increasingly intersects with MASLD and liver-fat risk.