Lipids: Metabolism, Nutrition & Health

Biography

Biography: Raman Puri

Abstract

The burden of cardiovascular disease (CVD) in Indian population is high regardless of their country of residence. World Health Organisation estimates 60% of world’s cardiac patients will be Indians with 50% of CVD related deaths occurring in patients below 70 years compared to 23% in the West. Indian ethnicity is regarded as a non modifiable risk factor by CVD prevention guidelines. The mission of the LAI expert consensus statement on management of dyslipidaemia is to address early onset and higher risk for CVD in this population by simplifying the process of identification at an early age as well as to intensify treatment to aggressively mange risk factors including life style changes at a lower risk levels compared to other global guidelines. The choice of a lower target of LDL C of < 50 mg/dl and non-HDL C of < 80 mg/dl for the high risk group as well as secondary prevention will help India achieve the expected reduction in CVD. Adoption of non HDL-C as a co primary target will address atherogenic lipoprotein pattern that incorporates the low HDL and high Triglyceride level in this population. The consensus statement recommends a lower threshold for not using statin at < 5% but the use of life time risk assessment in this group. Reducing the age threshold for screening for CVD risk to 18 years (at entry to university education) is likely to have a greater impact in reducing the CVD epidemic. While considerable success is seen with the effort taken by LAI to implement the advice to Indian physicians, adoption of this expert advice by governmental bodies, other professional organisation within and outside India will provide a greater impetus to reduce premature CVD in this high risk population irrespective of their place of residence.