The Cardiological Society of India (CSI) has launched groundbreaking guidelines for managing dyslipidemia, a crucial step towards addressing the nation's diverse health challenges. Dyslipidemia, characterised by abnormal levels of lipids (fats) in the blood, poses significant health risks, yet often goes unnoticed due to its asymptomatic nature, unlike conditions like hypertension or diabetes.
Dr. Pratap Chandra Rath, President of CSI, underscored the urgency of proactive management, stating, "Dyslipidemia is a silent killer, often asymptomatic, unlike hypertension and diabetes." The new guidelines advocate for non-fasting lipid measurements, departing from traditional methods, to enhance accuracy in risk assessment and treatment planning. Elevated LDL-C (low-density lipoprotein cholesterol) remains a primary target, while non-HDL cholesterol is prioritised for patients with high triglyceride levels (>150 mg/dL).
"Aggressive targets are proposed 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 Lipid Guidelines. "These patients should aim for LDL-C levels below 55 mg/dL or non-HDL levels below 85 mg/dL."
Lifestyle modifications play a pivotal role in managing dyslipidemia, with emphasis on dietary changes aimed at reducing sugar and carbohydrate intake. Regular exercise and practices like yoga are also encouraged for their cardiovascular benefits.
Treatment strategies outlined in the guidelines include statins, non-statin drugs, and newer agents like PCSK9 inhibitors or Inclisiran for cases where targets aren't met with conventional therapies. Patients with elevated triglycerides are advised to focus on reducing non-HDL cholesterol, with additional treatments such as Fenofibrate or fish oil for severe cases.
Genetic factors, notably familial hypercholesterolaemia, are more prevalent in India, necessitating early identification and familial screening. Dr. Ashwani Mehta, Senior Consultant Cardiologist, stressed the importance of evaluating lipoprotein (a) levels, known for their association with cardiovascular risk in the Indian population.
These guidelines aim to empower healthcare providers nationwide, ensuring standardised lipid management across laboratories. By adhering to defined risk categories and treatment goals, CSI's initiative seeks to mitigate cardiovascular risks effectively and promote long-term health across India.
