https://www.sciencedaily.com/releases/2019/11/191111141428.htm

When released in 2013, the ACC/AHA Cholesterol Guideline changed the approach to cholesterol management for people at high risk of cardiovascular diseases by recommending a risk-based approach over a target LDL cholesterol, or bad cholesterol, approach. The guideline identified four major groups of patients for whom statins would have the greatest benefit for preventing stroke and heart attacks, while also emphasizing the importance of adopting a heart healthy lifestyle. A new cholesterol guideline was published in 2018, but the risk-based approach did not change.

Researchers examined how the 2013 guidance for cholesterol management impacted patients in the long run by examining nationwide trends in total cholesterol, triglycerides and LDL-C, as well as high cholesterol awareness and statin usage. The Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES) was used to assess trends in lipid levels between 2005-2006, 2011-2014 and 2015-2016 (before, during and after the guideline release). Since there were less than 50 people in each NHANES cycle with an LDL-C of greater than or equal to 190 mg/dL, this group was excluded, along with people who were under the age of 20, pregnant or breastfeeding.