Alshamiri Mostafa, Ghanaim Mahmood Mohammed Ali, Barter Philip, Chang Kuan-Cheng, Li Jian-Jun, Matawaran Bien J, Santoso Anwar, Shaheen Sameh, Suastika Ketut, Thongtang Nuntakorn, Yusof Ahmad Km
Cardiac Science Department, King Saud University, Riyadh, Kingdom of Saudi Arabia,
Emergency Department, Dubai Hospital, Dubai, United Arab Emirates.
Int J Gen Med. 2018 Jul 18;11:313-322. doi: 10.2147/IJGM.S160555. eCollection 2018.
Cardiovascular disease (CVD) is a growing burden across the world. In Asia and the Middle East, in particular, CVD is among the most prevalent and debilitating diseases. Dyslipidemia is an important factor in the development of atherosclerosis and associated cardiovascular events, and so effective management strategies are critical to reducing overall cardiovascular risk. Multiple dyslipidemia guidelines have been developed by international bodies such as the European Society of Cardiology/European Atherosclerosis Society and the American College of Cardiology/American Heart Association, which all have similarities in practice recommendations for the optimal management of dyslipidemia. However, they differ in certain aspects including pharmacological treatment, lifestyle modification and the target levels used for low-density lipoprotein cholesterol. The evidence behind these guidelines is generally based on data from Western populations, and their applicability to people in Asia and the Middle East is largely untested. As a result, practitioners within Asia and the Middle East continue to rely on international evidence despite population differences in lipid phenotypes and CVD risk factors. An expert panel was convened to review the international guidelines commonly used in Asia and the Middle East and determine their applicability to clinical practice in the region, with specific recommendations, or considerations, provided where current guideline recommendations differ from local practice. Herein, we describe the heterogeneous approaches and application of current guidelines used to manage dyslipidemia in Asia and the Middle East. We provide consensus management recommendations to cover different patient scenarios, including primary prevention, elderly, chronic kidney disease, type 2 diabetes, documented CVD, acute coronary syndromes and family history of ischemic heart disease. Moreover, we advocate for countries within the Asian and Middle East regions to continue to develop guidelines that are appropriate for the local population.
心血管疾病（CVD）在全球范围内的负担日益加重。特别是在亚洲和中东地区，CVD是最普遍且使人衰弱的疾病之一。血脂异常是动脉粥样硬化及相关心血管事件发生发展的重要因素，因此有效的管理策略对于降低整体心血管风险至关重要。欧洲心脏病学会/欧洲动脉粥样硬化学会以及美国心脏病学会/美国心脏协会等国际机构制定了多项血脂异常指南，这些指南在血脂异常最佳管理的实践建议方面都有相似之处。然而，它们在某些方面存在差异，包括药物治疗、生活方式改变以及低密度脂蛋白胆固醇的目标水平。这些指南背后的证据通常基于西方人群的数据，其对亚洲和中东地区人群的适用性在很大程度上未经检验。因此，尽管亚洲和中东地区人群在血脂表型和心血管疾病风险因素方面存在差异，但该地区的从业者仍继续依赖国际证据。为此召集了一个专家小组，对亚洲和中东地区常用的国际指南进行审查，并确定其在该地区临床实践中的适用性，在当前指南建议与当地实践不同时提供具体建议或考量因素。在此，我们描述了亚洲和中东地区目前用于管理血脂异常的指南的不同方法及应用情况。我们提供了共识性管理建议，以涵盖不同的患者情况，包括一级预防、老年人、慢性肾脏病、2型糖尿病、确诊的心血管疾病、急性冠状动脉综合征以及缺血性心脏病家族史。此外，我们倡导亚洲和中东地区的国家继续制定适合当地人群的指南。
