Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East. (15th December 2016)

• Record Type: Journal Article
• Authors: Al Sayed, Nasreen; Al Waili, Khalid; Alawadi, Fatheya; Al-Ghamdi, Saeed; Al Mahmeed, Wael; Al-Nouri, Fahad; Al Rukhaimi, Mona; Al-Rasadi, Khalid; Awan, Zuhier; Farghaly, Mohamed; Hassanein, Mohamed; Sabbour, Hani; Zubaid, Mohammad; Barter, Philip
• Is Part Of: International journal of cardiology. Volume 225(2016)
• Page Start: 268
• Page End: 283
• Publication Date: 2016-12-15
• Subjects: AACE American Association of Clinical Endocrinologists -- ACC American College of Cardiology -- ACE Africa Middle East Cardiovascular Epidemiological -- AHA American Heart Association -- ASCVD atherosclerotic cardiovascular disease -- BMI body mass index -- CAD coronary artery disease -- CK creatine phosphokinase -- CKD chronic kidney disease -- CVD cardiovascular disease -- EAS European Atherosclerosis Society -- ESC European Society of Cardiology -- ESRD end-stage renal disease -- FCHL familial combined hyperlipidaemia -- FDA Food and Drug Administration -- FH familial hypercholesterolaemia -- FRF Framingham Risk Factor -- GFR glomerular filtration rate -- HDL high-density lipoprotein -- HIV human immunodeficiency virus -- IAS International Atherosclerosis Society -- LDL low-density lipoprotein -- Lp(a) lipoprotein(a) -- MetS metabolic syndrome -- RA rheumatoid arthritis -- TC total cholesterol -- TG triglyceride -- ULN upper limit of normal -- VLDL very low-density lipoprotein -- WC waist circumference; Cardiovascular disease -- Dyslipidaemia -- Guidelines -- Lipid disorder -- Middle East; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2016.09.081
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions. Methods: A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East. The panel considered existing international guidelines and regional clinical experience to develop recommendations. Results: The panel's recommendations include plasma lipid screening, ASCVD risk calculation and treatment considerations. The panel recommend that plasma lipid levels should be measured in all at-risk patients and at regular intervals in all adults from the age of 20 years. A scoring system should be used to calculate ASCVD risk that includes known lipid and non-lipid risk factors. Primary treatment targets include low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Lifestyle modifications should be first-line treatment for all patients; the first-line pharmacological treatment targeting plasma lipids in patients at moderate-to-high risk of ASCVD is statin therapy, with a number of adjunctive or second-line agents available. Guidance is also provided on the management of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia. Conclusions: These consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East. Highlights: Plasma lipid disorders are of increasing prevalence and concern in the Middle East. There is a lack of regional clinical guidelines. A regional, multidisciplinary expert panel has developed clinical recommendations. Recommendations are based on international guidelines and clinical experience. Guidance considers screening, risk levels, treatment and special populations.