Recommendations from expert consensus statement for management of dyslipidemia in Indian population by Lipid Association of India published on March 2016 in JAPI (Journal of The Association of Physicians of India)
Lipid Association of India (LAI) recommends screening of all adults for atherosclerotic cardiovascular disease risk factors especially lipid panel at age 20 or college entry. This should be done earlier if there is a family history of premature heart disease, dyslipidemia, obesity, or other risk factors.
LAI recommends LDL-C as primary target and Non HDL‐C as co‐primary treatment target.
Non-HDL-C comprises the cholesterol carried by all potentially atherogenic particles, including LDL, intermediate density lipoproteins, very low-density lipoproteins (VLDL) and VLDL remnants, chylomicron remnants, and lipoprotein (a).
Elevated TG is associated with increased risk of ASCVD, independent of LDL-C levels. Keep TG <150 mg/dL, preferably <100mg/dL.
The level of HDL-C is an important risk indicator and used in risk factor counting.
LAI recommends at least one fasting lipid profile though non-fasting lipid levels can be used in screening and in general risk estimation as per most international guidelines.
Risk Stratification for ASCVD (Atherosclerotic cardiovascular disease) by Lipid Association of India 2016
|Very High risk||
|Moderate Risk||2 major ASCVD risk factors|
|Low Risk||0-1 major ASCVD risk factors|
|Major ASCVD (Atherosclerotic cardiovascular disease) Risk Factors|
Treatment goals and statin initiation thresholds according to ASCVD risk categories as per Lipid Association of India 2016
|Risk Category||Treatment Goal||Consider Drug Therapy|
|LDL-C (mg/dl)||Non HDL-C (mg/dl)||LDL-C (mg/dl)||Non HDL-C (mg/dl)|
|Very High Risk||< 50||< 80||>=50||>=80|
|High Risk||< 70||< 100||>=70||>=100|
|Moderate Risk||< 100||< 130||>=100||>=130|
|Low Risk||< 100||< 130||>=130*||>=160|
|* In low risk group, consider therapy after an initial adequate non-pharmacological intervention for 3 months|