Bagheri Kholenjani Fahimeh, Shahidi Shahla, Vaseghi Golnaz, Ashoorion Vahid, Sarrafzadegan Nizal, Siavash Mansour, Heidarpour Maryam, Shahidi Shahrzad, Sadeghi Masoumeh, Mohammadifard Noushin, Jorjani Masoumeh, Mobarhan Majid Ghayour, Shafie Davood, Farshidi Hossein, Khorvash Fariborz, Ghabaei Mojdeh, Teimouri-Jervekani Zahra, Mortazavi Mojgan, Hajhashemi Valiollah, Roshanravan Neda, Yazdanpanah Leila, Davari Majid, Fatemi Behzad, Khorasani Elaheh, Hoseinkhani Ramesh, Zarean Elaheh, Ahmadi Alireza, Babadi Maryam Eghbali, Assareh Ahmadreza, Shadmani Mehdi, Kojuri Javad, Shirani Farimah, Sanjari Mojgan, Haghighatdoost Fahimeh, Hassannejad Razieh, Hashemi Elham, Moaddab Mohammad Hassan, Gheisari Alaleh, Dehghan Bahar, Naseri Mitra, Ghaemi Nosrat, Noohi Fereidoun, Haghdoost AliAkbar, Salehi-Abargouei Amin, Beigrezaie Sara, Doosti-Irani Amin, Ramezani-Jolfaie Nahid, Eraj Bijan, Hashemipour Mahin, Nematipour Ebrahim, Kopaei Mahmoud Rafieian
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2024 Mar 29;29:18. doi: 10.4103/jrms.jrms_318_23. eCollection 2024.
This guideline is the first Iranian guideline developed for the diagnosis, management, and treatment of hyperlipidemia in adults. The members of the guideline developing group (GDG) selected 9 relevant clinical questions and provided recommendations or suggestions to answer them based on the latest scientific evidence. Recommendations include the low-density lipoprotein cholesterol (LDL-C) threshold for starting drug treatment in adults lacking comorbidities was determined to be over 190 mg/dL and the triglyceride (TG) threshold had to be >500 mg/dl. In addition to perform fasting lipid profile tests at the beginning and continuation of treatment, while it was suggested to perform cardiovascular diseases (CVDs) risk assessment using valid Iranian models. Some recommendations were also provided on lifestyle modification as the first therapeutic intervention. Statins were recommended as the first line of drug treatment to reduce LDL-C, and if its level was high despite the maximum allowed or maximum tolerated drug treatment, combined treatment with ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, or bile acid sequestrants was suggested. In adults with hypertriglyceridemia, pharmacotherapy with statin or fibrate was recommended. The target of drug therapy in adults with increased LDL-C without comorbidities and risk factors was considered an LDL-C level of <130 mg/dl, and in adults with increased TG without comorbidities and risk factors, TG levels of <200 mg/dl. In this guideline, specific recommendations and suggestions were provided for the subgroups of the general population, such as those with CVD, stroke, diabetes, chronic kidney disease, elderly, and women.
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