Below 40? You Should Already Be Getting Screened for Cholesterol, Heart Attack Risks
New medical guidelines aim to head off damage early with lifestyle changes, screening tests and medication.
New medical guidelines aim to head off damage early with lifestyle changes, screening tests and medication.
Adults should be screened and treated for high cholesterol starting at age 30, if not sooner, according to new clinical guidelines, lowering the age by at least a decade at a time when heart attacks are becoming more common in younger adults.
The goal is to shift to a more proactive approach to head off problems in younger years, rather than starting lifestyle changes and medical treatment in middle age when a patient may already have damage in their arteries, said Dr Roger Blumenthal, chair of the committee of cardiologists that wrote the new guidelines.
Growing research shows how much damage can be done when levels of LDL, or “bad,” cholesterol stay high in the blood for years, he said.
At the same time, more medicines have become available to lower cholesterol, along with screening tests and a new online tool that allows people 30 and older to calculate their risk of cardiovascular disease.
“We need to pay attention much earlier,” said Blumenthal, director of preventive cardiology at Johns Hopkins Medicine.
The guidelines, published Friday in two leading cardiology journals, were issued by 11 medical associations, including the American College of Cardiology and American Heart Association.
These organisations set standards for medical professionals from family doctors to cardiologists.
Approximately 25% of U.S. adults—and 20% of adolescents—have high LDL cholesterol.
For adults, especially, that increases their risk of heart attacks and strokes because it causes plaque-forming particles to build up in their arteries over time, hardening and narrowing them.
Doctors are being urged to counsel children and adolescents on diet and exercise, avoiding tobacco and other healthy lifestyle habits.
More young people are being diagnosed with diabetes and other conditions that put them at higher risk of cardiovascular events.
“If we want to talk about eliminating heart disease and heart attacks, treating cholesterol is one of the most important things,” said Dr Sadiya Khan, professor of cardiovascular epidemiology at Northwestern University Feinberg School of Medicine. She wasn’t involved in writing the recommendations.
The new guidelines offer a number of different ways doctors can determine whether a person’s at risk.
Everyone should get a blood test once to measure their levels of lipoprotein(a), another type of “bad” cholesterol linked to heart disease.
Researchers say Lp(a), which is genetic, significantly increases the risk of cardiovascular disease, and a test can identify risks for people who are otherwise healthy.
Testing for another protein, apolipoprotein B, can also be performed for those with high triglycerides, diabetes or other conditions, the guidelines say.
Research suggests it is a better predictor of heart disease risk than LDL cholesterol. undefined undefined Men aged 40 and older and women aged 45 and older with a borderline risk of heart attack or stroke may also get a coronary artery calcium scan to check for plaque buildup in arterial walls.
Children should be screened for cholesterol and other lipids once between ages 9 and 11, backing an existing recommendation by the American Academy of Pediatrics.
As part of the new guidelines, young adults should be screened beginning at age 19 and every five years after that.
People should be screened for their risk of cardiovascular disease starting at age 30, using an AHA online calculator called
Prevent that measures risk based on a person’s cholesterol, blood pressure, and other indicators. Screening was previously recommended beginning at age 40, using a different tool.
Young adults should be offered cholesterol-lowering medications if their LDL cholesterol is 160 milligrams per deciliter, according to the guidelines.
The same is true if they have a family history of atherosclerotic disease at an early age or a high risk of developing it over the next three decades as measured by the Prevent calculator.
Adults with genetically high cholesterol should also be put on medication. undefined undefined
While the end result of additional screening may mean more people end up on cholesterol-lowering drugs, younger people may be able to avoid high doses.
“If you identify someone at risk earlier in life, you may not need to treat them with as intensive a statin regimen because you have time on your side,” said Dr Steven Nissen, a preventive cardiologist at the Cleveland Clinic, who wasn’t involved in writing the new guidelines.
From bushland greens to valley reds, the country’s most awarded designers are proving that the best colour palette was never on a swatch card; it was outside the window all along.
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From bushland greens to valley reds, the country’s most awarded designers are proving that the best colour palette was never on a swatch card; it was outside the window all along.
Walk through the Australian bush, and you’ll find a green that no paint chart quite captures. Eucalyptus canopy filtered through dust, heat and distance, grey at the edges, sometimes almost silver, never one fixed shade.
For decades, Australian interiors avoided it for exactly that reason. It was much easier to paint the walls white and look at the landscape.
That is no longer the case. Across this year’s Dulux Colour Awards, the celebrated projects shared an unmistakable thread: colour drawn not from trend forecasts or mood boards, but from the ground the buildings stand on.
Bushland greens, harbour blues, valley reds, coastal aquas are a palette with terroir, if such a thing can be said of paint.
“There’s a strong sense that designers are moving beyond safe, uniform schemes and embracing colours that reflect the local Australian landscape,” says Dulux Colour and Design Manager Lauren Treloar.
She points to greyish greens echoing coastal bushland, cool blues that nod to Sydney’s harbourside light, and rust-toned reds pulled from inland, rural country. “These shades feel rich, earthy and versatile.”
White walls, grey stone, maybe navy if a client was game, that was the old formula. Now colour is being used to describe where a house actually is, not just how it looks.
Few projects made that argument more persuasively than Nithsdale, an 1890s villa in Stanmore, restored and extended by Studio Prineas as an intergenerational family home.
Once compromised by decades of unsympathetic renovation, the house has been restored to something like coherence, and colour has done much of the heavy lifting.
Architect Rachel Prineas didn’t stop at a front door or a strip of trim.
She drenched the entire exterior in two deep tones, Dulux Bronze Icon and Tambo Tank, pulling render, timber and ironwork into one chromatic field, lifted straight from the native planting around the house, species indigenous to Wangal Country. The building and its garden start to blur into each other.
Judge Ben Peake, Principal at Carter Williamson Architects, called the result mature and sophisticated, praising the discipline behind it: deliberate selections lifted from the immediate native landscape rather than abstracted from it.
The effect is a house that no longer sits in its garden so much as it recedes into it, camouflage as design strategy, and a quietly radical rebuttal to the idea that heritage colour has to mean caution.

If Nithsdale shows landscape dictating a single, disciplined hue, The View, this year’s Residential Interior winner, designed by Studio Shields in the treetops of the Yarra Valley, shows what happens when an entire palette is built from the shifting conditions of a single place over time.
Seven years, start to finish. The colour scheme evolved right alongside the build, tones tested on site, adjusted through the seasons, checked against the light as it moved across the valley.
“The palette draws from oxidised earth, eucalyptus canopy, dry grasses and shifting skies, allowing the interior to feel inseparable from the landscape,” says designer Ruby Shields.
Chartreuse and olive pick up the bushland outside the windows. Burgundy and earthy reds anchor the more intimate rooms, echoing soil and aged timber. Powdered electric blues cut through the warmth for clarity.
It is, in Shields’ words, less a single decision than a tonal narrative, unfolding room by room as a considered journey.
Judge Sarah Jane-Pyke, of Arent&Pyke, singled out the precision of that placement, and the cohesion it created, proof, she said, of how thoughtfully deployed colour can enhance the texture of everyday life.
It’s a long way from colour as decoration. Here, it functions closer to memory: a way of encoding a specific valley, its light and its seasons, into the walls of a house.

Not every project translating “place” into paint sits in the Australian bush.
Te Pākau Maru, a 63-home development on former brownfield sites in New Brighton, Christchurch, took its name, meaning “the sheltering wing,” or “the place of joy”, from a gift by Ven Dr Lyndon Drake, and built its exterior palette around the beach, sea and sky.
What ties Nithsdale, The View and Te Pākau Maru together isn’t a shared shade; it’s a method.
Each project treats its palette as more of a site survey than a style choice, asking what a place already looks like before deciding how a building should be painted.
Treloar sees this as central to where Australian and New Zealand design is heading.
Warm neutrals are doing particularly well in the Australian climate right now, she says, softening rooms without losing their contemporary edge, and sitting easily next to the timber, linen and stone that anchor so many of these projects. The bigger shift, though, is about provenance. Designers can increasingly tell you why a colour belongs in a house, not just that it looks good in it.
There’s a practical lesson in all this for anyone renovating or building right now: skip the trend report. Step outside instead. Look at the ground, the trees, the light at a particular time of day. Ask what the house is already surrounded by.
As these award-winning projects prove, the answer was often there all along; you just have to be willing to bring it inside.
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