Novel Guidelines Expand Heart Disease Risk Assessment with Genetic Testing and Calcium Scans

If you’re concerned about keeping your heart healthy, there are many well-established steps you can take, including dietary changes and medication. But what about risk factors that are less easily modified? New recommendations from the American Heart Association (AHA) and the American College of Cardiology (ACC) introduce a genetic test to monitor heart health, alongside updated guidelines for coronary artery calcium (CAC) scanning. These changes aim to provide a more comprehensive assessment of an individual’s lifetime risk of heart disease and enable earlier intervention.

Lipoprotein(a) Testing: A New Genetic Marker

The AHA and ACC now recommend that adults be tested for lipoprotein(a) [Lp(a)], a genetically determined lipid that can increase the risk of heart disease. According to the updated guidelines, a single test in adulthood is generally sufficient, as lifestyle changes have minimal impact on Lp(a) levels. This aligns with a broader medical effort to assess people’s lifetime risk of heart disease.

Dr. Roger S. Blumenthal, head of the committee that wrote the new guidelines, explained in a statement that earlier testing can help individuals at risk of heart disease access medication sooner. “While we desire to endeavor to optimize healthy lifestyle habits as the first step to lower cholesterol, we realize that if lipid numbers aren’t within the desirable range after a period of lifestyle optimization, we should consider adding lipid-lowering medication earlier than we would have considered 10 years ago,” AHA/ASA explained.

Coronary Artery Calcium (CAC) Scans

In addition to Lp(a) testing, the revised guidelines recommend that at-risk men and women over 40 and 45, respectively, undergo a noncontrast coronary artery calcium (CAC) scan. This scan measures the amount of calcium in the arteries, providing further insight into the risk of heart disease.

A Holistic Approach to Risk Assessment

The updated guidelines also call for using a different method for risk assessment overall. Taken together, these changes represent a shift towards a more proactive and personalized approach to cardiovascular care, with the goal of leading to more people living longer and healthier lives.

Resources for Further Information

• American Heart Association Guidelines and Statements
• American College of Cardiology Guidelines
• Journal of the American College of Cardiology Guidelines
• 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients