The Cardiologist Society of India (CSI) has introduced new guidelines recommending cholesterol testing starting at age 18, marking a significant shift in preventive healthcare. Non-fasting measurements are now advised for assessing lipid profiles, aiming to streamline testing and early detection of dyslipidemia in India.
Understanding Dyslipidemia Dyslipidemia, characterized by imbalances in cholesterol levels (including high LDL-cholesterol and low HDL-cholesterol), poses a substantial risk for cardiovascular diseases such as heart attacks, strokes, and peripheral artery disease.
Prevalence and Risks in India In India, dyslipidemia is widespread, affecting 81% of the population according to the ICMR-INDIAB-17 study published in The Lancet. Variations exist across states, with higher rates observed in urban areas compared to rural regions.
Unique Challenges in India Dr. JPS Sawhney, chairman of cardiology at Sir Gangaram Hospital, highlights India's distinct lipid profile and the need for tailored guidelines. Factors contributing to high heart attack rates among younger individuals include tobacco use, central obesity, sedentary lifestyles, and poor dietary habits.
Revised Guidelines The new CSI guidelines propose aggressive LDL-C targets for high-risk patients, aiming for levels below 55 mg/dL or non-HDL levels below 85 mg/dL. Dr. Pratap Chandra Rath, president of CSI, stresses the importance of early detection and proactive management to mitigate the silent threat of dyslipidemia.
Benefits of Non-Fasting Measurements Dr. Durjati Prasad Sinha, honorary general secretary at CSI, underscores the convenience and accessibility of non-fasting lipid tests. These changes aim to increase testing rates, particularly among younger adults and those at risk due to family history or genetic predisposition.
Implementation and Impact The new guidelines advocate for the first lipid profile at age 18 or earlier for individuals with a family history of premature heart disease or familial hypercholesterolemia. Targets for LDL-C and non-HDL-C levels vary based on risk, emphasizing personalized care and lifestyle modifications.
CSI's updated guidelines represent a proactive approach to managing dyslipidemia in India, prioritizing early intervention and tailored treatments. By integrating non-fasting measurements and setting aggressive targets, these guidelines aim to curb the prevalence and impact of cardiovascular diseases nationwide.
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