New Cholesterol Standard in Brazil Tightens Goals and Could Save Millions of Lives

Written by Caio Aviz

Published on 30/09/2025 at 20:23

Mapa do Brasil, estetoscópio e exame de colesterol representam as novas metas rígidas adotadas pela Sociedade Brasileira de Cardiologia em 2025.

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Brazil Redefines Cholesterol Levels to Prevent Heart Attacks and Strokes

On Wednesday, September 24, 2025, the Brazilian Society of Cardiology (SBC) presented the new Guideline on Dyslipidemias and Atherosclerosis Prevention.

The document replaces the version published in 2017. It tightens the limits considered healthy for LDL cholesterol and adopts the PREVENT score as the official reference.

The American Heart Association launched the PREVENT score in 2024. Now, health professionals in Brazil use this system to measure cardiovascular risks more accurately.

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Changes in Cholesterol Targets

The committee led by Fabiana Hanna Rached included specialists such as Marcio Hiroshi Miname, Viviane Zorzanelli Rocha, and André Zimerman.

Brazil now defines new thresholds for LDL. Patients with cardiovascular events should keep their cholesterol at up to 40 mg/dL.

For low risk, the limit has dropped from 130 mg/dL to 115 mg/dL. In the intermediate category, the level was adjusted to 100 mg/dL.

For extreme risk, individuals with 190 mg/dL or more of LDL automatically enter the category. LDL is known as bad cholesterol.

These changes reflect international consensus. They reinforce the importance of intensive and early control to reduce the silent progression of atherosclerosis.

Use of the PREVENT Score in Brazil

The PREVENT score calculates the probability of heart attack, stroke, or heart failure in 10 to 30 years.

According to a 2024 study by the American Heart Association, the model presented a C statistic of 0.774 in women and 0.736 in men.

This index indicates good predictive capability. However, the SBC warns that, due to Brazil’s ethnic diversity, equity auditing will still be necessary.

So far, the country does not have its own score based on national population data. The PREVENT is merely an international adaptation.

Combined Therapies to Achieve Targets

To reach the new objectives, the guideline recommends starting combined therapies in high-risk cases, therefore the guidance should be followed with clinical rigor.

In addition, the use of statins associated with ezetimibe, PCSK9 inhibitors, or bempedoic acid can reduce LDL by up to 65%, which strengthens treatment.

Furthermore, these effects appear already in the early stages of treatment, and consequently, the SBC emphasizes that the strategy avoids the so-called therapeutic inertia, a common problem among many patients.

Similarly, this condition is characterized by delays in medication adjustments, as it occurs when targets are not achieved with statins alone.

Finally, the guideline reinforces that a reduction of 39 mg/dL in LDL can decrease the risk of cardiovascular events by up to 25%, making this approach indispensable.

Healthy Habits Remain Essential

Although the guideline emphasizes medication, experts highlight the importance of lifestyle habits. Additionally, they advocate for consistent changes to improve long-term outcomes.

Thus, a balanced diet, regular exercise, adequate sleep, quitting smoking, and stress management become essential. Without these precautions, benefits are unlikely to manifest.

According to the SBC, Brazil faces an increase in obesity. Furthermore, the aging population and the rise of sedentary lifestyles significantly amplify cardiovascular risks.

As a result, the new targets aim to reduce cardiovascular mortality. After all, this condition still represents the leading cause of death in the country, according to specialists from the Brazilian Society of Cardiology.

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New Cholesterol Standard in Brazil Tightens Goals and Could Save Millions of Lives

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