Menon Anil S, Kotwal Narendra, Singh Yashpal, Girish R
Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India.
Department of Endocrinology, Army Hospital (R and R), New Delhi, India.
Indian J Endocrinol Metab. 2015 Sep-Oct;19(5):546-53. doi: 10.4103/2230-8210.163105.
Statins have become an important drug in preventing the occurrence of atherosclerotic cardiovascular disease (ASCVD). The effectiveness of statins in reducing ASCVD has been established in large-scale clinical trials. The lipid management guidelines have been periodically modified due to accumulating evidence about the proportionate benefit achieved with a progressive reduction in cholesterol levels with higher doses of statins and even in those at low risk of development of ASCVD. The current American College of Cardiology/American Heart Association guidelines have based its recommendations from data gathered exclusively from randomized controlled trials. It has simplified the use of statins, but also raised questions regarding the validity of its cardiovascular event risk prediction tool. Epidemiology of cardiovascular disease in India differs from the western population; there is an increased the prevalence of metabolic syndrome and atherogenic dyslipidemia phenotype a group not addressed in the current guidelines. The guidelines are based on trials, which do not have a representative South Asian population. This article reviews the relevant literature, and examines the issues involved in adopting the guidelines to the Indian population.
他汀类药物已成为预防动脉粥样硬化性心血管疾病（ASCVD）的重要药物。他汀类药物在降低ASCVD方面的有效性已在大规模临床试验中得到证实。由于越来越多的证据表明，使用高剂量他汀类药物逐步降低胆固醇水平，甚至在ASCVD发生风险较低的人群中，也能按比例获得相应益处，血脂管理指南也在定期修订。美国心脏病学会/美国心脏协会当前的指南是基于仅从随机对照试验收集的数据提出建议的。它简化了他汀类药物的使用，但也引发了关于其心血管事件风险预测工具有效性的问题。印度心血管疾病的流行病学情况与西方人群不同；代谢综合征和致动脉粥样硬化血脂异常表型的患病率有所增加，而这是当前指南未涉及的人群。这些指南所依据的试验中没有具有代表性的南亚人群。本文回顾了相关文献，并探讨了将这些指南应用于印度人群所涉及的问题。
