LDL targets for children with family history of coronary artery disease

Thanks for asking—family history matters. With a first‑degree relative who has coronary artery disease, the current best approach is tighter LDL control in their children, even in the 30s. - Target: LDL <70 mg/dL is a prudent goal when lifetime risk is elevated (as we’ve been advocating for South Asians and those with family history). If additional risk is present—high Lp(a), elevated CAC, diabetes, or multiple risk factors—aim closer to <55 mg/dL. - “Know your numbers”: check a fasting lipid panel, ApoB (goal <65–70 mg/dL; <55 if very high risk), Lp(a) once in a lifetime, blood pressure, and waist-to-height ratio (<0.5). Use lifestyle first; add medications if needed to reach targets.