New Delhi: The Cardiological Society of India (CSI) on Thursday released the first Indian guidelines for the treatment of dyslipidemia, a critical risk factor for cardiovascular and peripheral arterial diseases.
This initiative will help address the unique challenges and variations in the prevalence of dyslipidemia across the country by incorporating extensive data.
Dyslipidemia, characterized by high total cholesterol, high LDL cholesterol (bad cholesterol), high triglycerides, and low HDL cholesterol (good cholesterol), is a critical risk factor for cardiovascular diseases such as heart attacks, strokes, and peripheral artery disease.
The prevalence of dyslipidemia in India is alarmingly high, with significant interstate variations and particularly high rates in urban areas, experts said.
Speaking on the severity of dyslipidemia, Dr Pratap Chandra Rath, President, CSI, said, "Dyslipidemia is a silent killer, often asymptomatic, unlike hypertension and diabetes."
He highlighted the importance of proactive management and early detection. The new guidelines recommend nonfasting lipid measurements for risk estimation and treatment, rather than traditional fasting measurements, Dr. Rath said.
Dr Durjati Prasad Sinha, general secretary of CSI, said: "Non-fasting lipid measurements make testing more convenient and accessible, encouraging more people to get tested and treated. The guidelines recommend the first lipid profile at age 18, or earlier with a positive result. "family history of premature heart disease or familial hypercholesterolemia."
The general population and low-risk individuals should keep LDL-C levels below 100 mg/dL and non-HDL-C levels below 130 mg/dL. High-risk people, such as those with diabetes or hypertension, should aim for LDL-C levels below 70 mg/dL and non-HDL below 100 mg/dL, he said.
"Aggressive targets are suggested for very high-risk patients, including those with a history of heart attacks, angina, stroke, or chronic kidney disease," explained Dr. J. P. S. Sawhney, chairman of the Department of Cardiology at Sir Gangaram Hospital and chairman of the Guidelines. of lipids.
"These patients should aim for LDL-C levels below 55 mg/dL or non-HDL levels below 85 mg/dL," he said. There is an emphasis on lifestyle modifications as a cornerstone of dyslipidemia treatment, Dr. Sawhney added.
Keeping in mind the Indian eating habits, it is recommended to reduce the intake of sugar and carbohydrates as they contribute more to blockages compared to moderate fat consumption.
Regular exercise and yoga, which offer cardioprotective benefits and are culturally relevant, are also recommended.
"High LDL and non-HDL levels can be controlled with a combination of statins and oral non-statin drugs. If targets are not achieved, injectable lipid-lowering drugs such as PCSK9 inhibitors or Inclisiran are recommended," said Dr S Ramakrishnan. . , professor of cardiology at AIIMS, Delhi, and co-author of the Lipid Guidelines.
For patients with high triglycerides (>150 mg/dL), the goal is non-HDL cholesterol, Dr. Ramakrishnan said.
Lifestyle changes, such as exercising regularly, quitting alcohol and tobacco, and reducing sugar and carbohydrate intake, are crucial. In patients with heart disease, stroke or diabetes, statins, non-statin medications and fish oil (EPA) are recommended, he said.
"Genetic causes of dyslipidemia, such as familial hypercholesterolemia, are more common in India than in other parts of the world. It is essential to identify and treat these cases early through cascade screening of family members," emphasized Dr. Ashwani Mehta, Senior Consultant Cardiologist. at Sir Ganga Ram Hospital and co-author of the Lipid Guides.
This initiative will help address the unique challenges and variations in the prevalence of dyslipidemia across the country by incorporating extensive data.
Dyslipidemia, characterized by high total cholesterol, high LDL cholesterol (bad cholesterol), high triglycerides, and low HDL cholesterol (good cholesterol), is a critical risk factor for cardiovascular diseases such as heart attacks, strokes, and peripheral artery disease.
The prevalence of dyslipidemia in India is alarmingly high, with significant interstate variations and particularly high rates in urban areas, experts said.
Speaking on the severity of dyslipidemia, Dr Pratap Chandra Rath, President, CSI, said, "Dyslipidemia is a silent killer, often asymptomatic, unlike hypertension and diabetes."
He highlighted the importance of proactive management and early detection. The new guidelines recommend nonfasting lipid measurements for risk estimation and treatment, rather than traditional fasting measurements, Dr. Rath said.
Dr Durjati Prasad Sinha, general secretary of CSI, said: "Non-fasting lipid measurements make testing more convenient and accessible, encouraging more people to get tested and treated. The guidelines recommend the first lipid profile at age 18, or earlier with a positive result. "family history of premature heart disease or familial hypercholesterolemia."
The general population and low-risk individuals should keep LDL-C levels below 100 mg/dL and non-HDL-C levels below 130 mg/dL. High-risk people, such as those with diabetes or hypertension, should aim for LDL-C levels below 70 mg/dL and non-HDL below 100 mg/dL, he said.
"Aggressive targets are suggested for very high-risk patients, including those with a history of heart attacks, angina, stroke, or chronic kidney disease," explained Dr. J. P. S. Sawhney, chairman of the Department of Cardiology at Sir Gangaram Hospital and chairman of the Guidelines. of lipids.
"These patients should aim for LDL-C levels below 55 mg/dL or non-HDL levels below 85 mg/dL," he said. There is an emphasis on lifestyle modifications as a cornerstone of dyslipidemia treatment, Dr. Sawhney added.
Keeping in mind the Indian eating habits, it is recommended to reduce the intake of sugar and carbohydrates as they contribute more to blockages compared to moderate fat consumption.
Regular exercise and yoga, which offer cardioprotective benefits and are culturally relevant, are also recommended.
"High LDL and non-HDL levels can be controlled with a combination of statins and oral non-statin drugs. If targets are not achieved, injectable lipid-lowering drugs such as PCSK9 inhibitors or Inclisiran are recommended," said Dr S Ramakrishnan. . , professor of cardiology at AIIMS, Delhi, and co-author of the Lipid Guidelines.
For patients with high triglycerides (>150 mg/dL), the goal is non-HDL cholesterol, Dr. Ramakrishnan said.
Lifestyle changes, such as exercising regularly, quitting alcohol and tobacco, and reducing sugar and carbohydrate intake, are crucial. In patients with heart disease, stroke or diabetes, statins, non-statin medications and fish oil (EPA) are recommended, he said.
"Genetic causes of dyslipidemia, such as familial hypercholesterolemia, are more common in India than in other parts of the world. It is essential to identify and treat these cases early through cascade screening of family members," emphasized Dr. Ashwani Mehta, Senior Consultant Cardiologist. at Sir Ganga Ram Hospital and co-author of the Lipid Guides.
