Roundup: Updated Guidelines Call for Earlier Action to Control Cholesterol; and More News

New Cholesterol Guidelines Call for Earlier Action to Prevent Heart Disease

Updated national guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) urge doctors and patients to act earlier to control unhealthy cholesterol levels, a major cause of heart attacks and strokes.

The updated recommendations, released this month, emphasize identifying risk sooner and treating elevated cholesterol earlier in life to reduce long-term damage to the arteries.

Heather Johnson, M.D., director of preventive cardiology for women's services with Baptist Health Heart & Vascular Care at the Christine E. Lynn Women's Health & Wellness Institute, helped shape the new guidelines. Dr. Johnson, who is also clinical affiliate associate professor for Florida Atlantic University, served on the writing committee, which was composed of representatives from the ACC, the AHA and nine other leading medical associations.

Experts estimate that about 1 in 4 U.S. adults has high levels of LDL cholesterol, often called “bad cholesterol.” LDL can lead to the buildup of fatty plaque inside arteries—a process known as atherosclerosis—that increases the risk of heart attack and stroke. Cardiovascular disease caused by this buildup remains the leading cause of death worldwide.

Earlier Prevention is the Central Message

A major theme of the new guidelines is earlier intervention to limit lifetime exposure to harmful cholesterol levels. Research shows that the longer LDL cholesterol remains elevated, the greater the chance of developing heart disease later in life.

That means prevention should start sooner—sometimes decades before symptoms appear. Doctors are encouraged to evaluate risk earlier and consider treatment earlier if lifestyle changes alone do not lower cholesterol enough.

Healthy habits remain the first line of defense. Maintaining a healthy weight, exercising regularly, avoiding tobacco, getting adequate sleep and eating a heart-healthy diet all help improve cholesterol levels.

However, if cholesterol remains elevated, experts now recommend considering medication sooner than in the past. Statins—drugs that reduce cholesterol production in the liver—remain the most common and effective treatment.

The guidelines also note that high cholesterol can begin to influence heart disease risk even in childhood and adolescence. Children may have high cholesterol due to inherited conditions or lifestyle habits. “Cholesterol screening is recommended for all children between the ages of 9-11 years not previously screened to help assess risk and guide care, in collaboration with clinicians, parents and caregivers,” states the news release on the new updated guidelines.

New Cholesterol Targets

The guidelines also reinforce lower LDL cholesterol targets to reduce long-term risk.

For people at borderline or intermediate risk of heart disease, the recommended LDL level is below 100 milligrams per deciliter (mg/dL). For individuals at high risk, the goal is below 70 mg/dL. People who already have cardiovascular disease may benefit from lowering LDL even further, to below 55 mg/dL.

Experts say keeping LDL cholesterol lower for longer provides significantly greater protection against future heart attacks and strokes.

A New Tool to Estimate Heart Risk

Doctors will also use an updated risk calculator called PREVENT, designed to estimate a person’s likelihood of having a heart attack or stroke within the next 10 or 30 years.

The tool uses information typically collected during routine checkups, including cholesterol levels, blood pressure, age and lifestyle habits. It categorizes people into four risk groups:

• Low risk: less than 3 percent chance of a heart attack or stroke within 10 years
• Borderline risk: 3 percent to under 5 percent
• Intermediate risk: 5 percent to under 10 percent
• High risk: 10 percent or greater

These categories help clinicians decide whether cholesterol-lowering medications should begin and how aggressive treatment should be.

Additional Tests Can Personalize Care

The guidelines also highlight tests that may help refine a person’s risk.

A coronary artery calcium (CAC) scan is a specialized CT scan that detects calcium deposits in the heart’s arteries—an early sign of plaque buildup. Finding calcium in the arteries may support starting treatment sooner.

Doctors may also measure lipoprotein(a), often called Lp(a), a cholesterol-related particle largely determined by genetics. Elevated Lp(a) significantly increases long-term risk of heart attack or stroke. Another test, apolipoprotein B, measures the number of cholesterol-carrying particles in the blood and may help identify hidden risk in people with diabetes or high triglycerides.

Learn about Baptist Health's Lipid Management Program to control cholesterol and othe risk factors.

New Study Links 12-Hour Overnight Fast to Better Heart Health

A recent study suggests that finishing your last meal at least three hours before bedtime could lead to significant heart and metabolic health benefits. Published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, this research highlights a simple lifestyle change that may improve how our bodies function overnight.

The study explored a specific type of time-restricted eating called "sleep-aligned extended overnight fasting." This approach focuses on extending the natural fasting period that occurs while you sleep. Researchers wanted to see if this method could improve cardiometabolic health—a term that covers your heart, blood vessels, and metabolism, which is how your body uses energy.

How the Study Worked

Researchers at Northwestern University conducted a randomized controlled trial involving 39 overweight or obese adults between the ages of 36 and 75. The participants were split into two groups for about seven and a half weeks.

One group, the intervention group, was instructed to extend their nightly fast to between 13 and 16 hours. The key was that they had to finish their last meal at least three hours before their usual bedtime. The other group, the control group, continued their regular eating habits, which typically involved a fasting period of 11 to 13 hours. Both groups were also told to dim the lights three hours before bed to help regulate their internal clocks.

What Researchers Discovered

The results showed several positive changes for the group that extended their overnight fast. A key finding was an improvement in nighttime blood pressure. Specifically, participants saw a better "dip" in their diastolic blood pressure during sleep. A healthy dip in blood pressure overnight is important because it allows your cardiovascular system to rest.

This group also experienced other benefits, including:

• A lower heart rate during the night.
• Higher heart rate variability, a sign of better cardiovascular and autonomic nervous system function. The autonomic nervous system controls involuntary actions like your heartbeat.
• Lower levels of the stress hormone cortisol at night.
• Better glucose regulation in the morning. When tested, their bodies showed a more efficient response to sugar, indicating improved insulin function.

This study suggests that the timing of your meals, especially in relation to sleep, plays a crucial role in your cardiometabolic health. By creating a longer fasting window that aligns with your sleep schedule, you may help strengthen the coordination between your body's internal clock and its metabolic processes.

Nearly Half of U.S. Children Aren’t Getting Enough Sleep—And Families Are Feeling the Impact

A new national survey suggests that sleep problems among children are more common than many parents realize—and the effects can ripple through the entire household.

According to the 2026 Sleep in America Poll from the National Sleep Foundation, about 44 percent of children in the United States do not consistently get the recommended amount of sleep for their age. The findings were released during Sleep Awareness Week (March 8–14) and highlight how children’s sleep habits affect family health and daily functioning.

A Widespread Sleep Gap

Sleep is essential for children’s physical growth, brain development, and emotional well-being. Yet the survey found that many children, particularly younger ones, regularly fall short of recommended sleep hours.

One major reason may be that parents often underestimate how much sleep their children actually need. On average, parents reported sleep expectations that were more than an hour shorter than guidelines from the National Sleep Foundation.

The National Sleep Foundation recommends different amounts of sleep depending on age:

• Infants (4–12 months) should sleep 12–16 hours per day, including naps.
• Toddlers (1–2 years) need about 11–14 hours.
• Preschoolers (3–5 years) should get 10–13 hours daily.
• School-age children (6–12 years) are recommended to sleep 9–12 hours per night.
• Teenagers (13–18 years) should aim for 8–10 hours.
• Adults generally need 7–9 hours of sleep each night.

This gap matters because insufficient sleep in children has been linked to several problems, including impaired learning — meaning difficulty concentrating, remembering information, or performing well in school. Long-term health risks, including higher chances of obesity, mental health concerns, and chronic illness later in life, are also associated with insufficient sleep in children.

When Kids Don’t Sleep, Families Don’t Either

The research also shows that sleep issues rarely affect just one person in a household.

Nearly 95 percent of parents say good sleep is essential for a well-functioning family, and most report noticeable changes in their child’s behavior when sleep is lacking. In fact:

• 86 percent of parents say good sleep improves children’s mood and behavior
• Nearly 70 percent say poor sleep harms their child’s mood and daytime functioning
• Four out of five parents say their own sleep suffers when their child sleeps poorly

Sleep experts say this “family sleep effect” happens because sleep schedules, bedtime routines, and nighttime awakenings often involve multiple household members.

Parents Play a Key Role

Despite recognizing the importance of sleep, nearly half of parents say they rarely or never talk with their children about healthy sleep habits.

Experts say improving sleep often begins with simple changes at home. Families can start by treating sleep as a core health habit—similar to nutrition and exercise.

Simple Habits That Support Better Sleep

The National Sleep Foundation recommends several practical steps families can take together:

• Get morning light exposure. Sunlight helps regulate the body’s internal clock, known as the circadian rhythm, which controls sleep and wake cycles.
• Encourage daily physical activity. About 30 minutes of exercise most days can improve sleep quality.
• Avoid caffeine after noon. Caffeine in coffee, sodas, energy drinks, or chocolate can interfere with falling asleep.
• Eat dinner earlier. Large meals within two hours of bedtime may disrupt sleep.
• Create a bedtime routine. Reading, stretching, or quiet conversation can signal to the brain that it’s time to wind down.
• Keep consistent sleep schedules—even on weekends. Irregular bedtimes can disrupt the body’s natural sleep rhythm.
• Limit screens before bed. A device-free hour helps prevent stimulation from light and content that can delay sleep.
• Optimize the bedroom environment. A cool, dark, and quiet room—around 65–68°F—supports better sleep.