|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 2 | Page : 134-135
Lipid association of India expert consensus statement on management of dyslipidemia in Indians 2016 - part 1
SS Iyengar1, Raman Puri2, SN Narasingan3
1 Department of Cardiology, Manipal Hospital, Bangalore, India
2 Department of Cardiology, Lipid Association of , IP Apollo Hospital, New Delhi, India
3 Department of Cardiology, SNN Diagnostic Centre, Chennai, India
|Date of Web Publication||7-Oct-2016|
A-26, 2nd Floor, South Extension Part-2, New Delhi - 110 049
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Iyengar S S, Puri R, Narasingan S N. Lipid association of India expert consensus statement on management of dyslipidemia in Indians 2016 - part 1. J Pract Cardiovasc Sci 2016;2:134-5
|How to cite this URL:|
Iyengar S S, Puri R, Narasingan S N. Lipid association of India expert consensus statement on management of dyslipidemia in Indians 2016 - part 1. J Pract Cardiovasc Sci [serial online] 2016 [cited 2021 Aug 3];2:134-5. Available from: https://www.j-pcs.org/text.asp?2016/2/2/134/191531
The burden of atherosclerotic cardiovascular disease (ASCVD) in India is alarmingly high and continues to increase exponentially. Not only Indians are at high risk of developing ASCVD, but also they usually get the disease at an early age, have a more severe form of the disease, and have poorer outcome compared with Western populations. Access to health care is also not optimal in India, and the treatment of ASCVD remains expensive. For all these reasons, the prevention of ASCVD becomes one of the most important public health goals for Indians.
The INTERHEART study has shown that dyslipidemia is the most important modifiable risk factor for ASCVD. This relates both to the high prevalence of dyslipidemia and also to the direct pathogenic association of lipid abnormalities with atherosclerosis. Accordingly, an extensive evidence base exists to support the value of effective management of dyslipidemia as one of the most important therapeutic interventions for prevention of ASCVD.
Numerous leading international societies have published guidelines for the management of dyslipidemia, but these guidelines are not directly applicable to Indians because of various reasons. Indians have unusually high prevalence of dyslipidemia, particularly at a younger age, and the pattern of dyslipidemia is also distinct compared with Western populations. The distribution and interplay of various other ASCVD risk factors and genetic susceptibility are also different. In addition, the population awareness about the prevention of ASCVD, cultural beliefs, socioeconomic conditions, etc., are also quite different. For these reasons, it is important to formulate policies and guidelines that accommodate these differences and propose recommendations that are best suited for our conditions. To meet this objective, the Lipid Association of India (LAI) has undertaken the task to develop a consensus document on management of dyslipidemia in Indians. This consensus document is divided into two parts - part 1 deals with all common issues related to lipid management encountered during routine clinical practice and the part 2 deals with the management of dyslipidemia in special patient populations such as those with acute coronary syndrome, familial dyslipidemias, chronic kidney disease, etc., Part 1 of the consensus document has already been published recently. The key highlights of this document are:
- A new ASCVD risk assessment algorithm that is based mainly on risk factor counting. It has the advantages of being simple, easy to use, and more evidence-based as compared to various risk scores that are not applicable to Indians
- Emphasis on lifetime risk assessment in those who are at low 10-year ASCVD risk
- Combining ASCVD risk-based as well low-density lipoprotein (LDL) cholesterol level-based approach for guiding lipid management
- Stricter targets for LDL cholesterol lowering in Indians - <50 mg/dl for those at very high risk and <70 mg/dl for those at high risk of ASCVD
- Recognizing the value of nonhigh density lipoprotein cholesterol as an important risk factor for Indians and including it as a coprimary target for lipid lowering therapy
- These guidelines were presented and discussed in the LAI meeting August meeting at Aerocity New Delhi 2016 [Figure 1],[Figure 2].
For more details, please read the full document at http://www.japi.org/march_2016_special_issue/contents.html (Journal of Physicians of India, March 2016 special issues). Alternately, for executive summary, please visit http://www.jcpconline.org/currentissue.asp?sabs = n (Journal of Clinical and Preventive Cardiology, April-June 2016 issue).
[Figure 1], [Figure 2]