In the past, decisions about treatment for risks of high cholesterol were focused on whether a person was likely to have a heart attack or stroke within the next ten years. However, younger adults with moderately elevated cholesterol levels may benefit from earlier treatment if they have hidden risks. That is the thinking behind new cholesterol treatment guidelines from the American Heart Association and American College of Cardiology. Overall, the updated guidelines recommend a more aggressive approach to management of fats in the blood, including cumulative damage cholesterol can cause over a lifetime. Authors acknowledge that explaining this lifetime risk to patients by medical care providers requires detailed conversations.