Sir Ganga Ram Hospital, New Delhi, India.
All India Institute of Medical Sciences, Delhi, India.
Indian Heart J. 2024 Mar;76 Suppl 1(Suppl 1):S6-S19. doi: 10.1016/j.ihj.2023.11.271. Epub 2023 Dec 4.
Dyslipidemias are the most important coronary artery disease (CAD) risk factor. Proper management of dyslipidemia is crucial to control the epidemic of premature CAD in India. Cardiological Society of India strived to develop consensus-based guidelines for better lipid management for CAD prevention and treatment. The executive summary provides a bird's eye-view of the 'CSI: Clinical Practice Guidelines for Dyslipidemia Management' published in this issue of the Indian Heart Journal. The summary is focused on the busy clinician and encourages evidence-based management of patients and high-risk individuals. The summary has serialized various aspects of lipid management including epidemiology and categorization of CAD risk. The focus is on management of specific dyslipidemias relevant to India-raised low density lipoprotein (LDL) cholesterol, non-high density lipoprotein cholesterol (non-HDL-C), apolipoproteins, triglycerides and lipoprotein(a). Drug therapies for lipid lowering (statins, non-statin drugs and other pharmaceutical agents) and lifestyle management (dietary interventions, physical activity and yoga) are summarized. Management of dyslipidemias in oft-neglected patient phenotypes-the elderly, young and children, and patients with comorbidities-stroke, peripheral arterial disease, kidney failure, posttransplant, HIV (Human immunodeficiency virus), Covid-19 and familial hypercholesterolemia is also presented. This consensus statement is based on major international guidelines (mainly European) and expert opinion of lipid management leaders from India with focus on the dictum: earlier the better, lower the better, longer the better and together the better. These consensus guidelines cannot replace the individual clinician judgement who remains the sole arbiter in management of the patient.
血脂异常是冠心病(CAD)最重要的危险因素。适当的血脂异常管理对于控制印度早发性 CAD 的流行至关重要。印度心脏病学会努力制定基于共识的指南,以更好地管理血脂,预防和治疗 CAD。执行摘要提供了本期《印度心脏杂志》发表的“CSI:血脂异常管理临床实践指南”的概览。该摘要重点关注忙碌的临床医生,并鼓励对患者和高危个体进行基于证据的管理。摘要序列化了血脂管理的各个方面,包括 CAD 风险的流行病学和分类。重点是管理与印度高 LDL 胆固醇、非高密度脂蛋白胆固醇(非-HDL-C)、载脂蛋白、甘油三酯和脂蛋白(a)相关的特定血脂异常。药物治疗(他汀类药物、非他汀类药物和其他药物)和生活方式管理(饮食干预、体育活动和瑜伽)也进行了总结。还介绍了在常被忽视的患者表型(老年人、年轻人和儿童,以及患有中风、外周动脉疾病、肾衰竭、移植后、HIV(人类免疫缺陷病毒)、Covid-19 和家族性高胆固醇血症的患者)中血脂异常的管理。该共识声明基于主要的国际指南(主要是欧洲的指南)和印度血脂管理专家的意见,重点是以下原则:越早越好,越低越好,持续时间越长越好,综合治疗效果越好。这些共识指南不能替代临床医生的个体判断,临床医生仍然是患者管理的唯一裁决者。