India tops the charts when it comes to bad eating habits and results are quite visible on Indian bodies. Be it your heart health or overall well-being, we are on the verge of winning the race of the most unhealthy country. The statistics are speaking for it, cardiovascular illnesses have become a major source of death and morbidity in India. According to the Indian Council of Medical Research (ICMR), CVDs cause roughly 28% of all deaths in the country. The rising prevalence of risk factors such as dyslipidemia, hypertension, diabetes, and lifestyle changes all play a crucial role in this health catastrophe. The Cardiological Society of India (CSI) recently issued ground-breaking guidelines emphasizing the value of early lipid profiling and the ease of non-fasting examinations. These new recommendations represent a big step forward in India’s fight against cardiovascular diseases (CVDs). In this extensive article, we will look at the essential parts of these guidelines, the facts that support their importance, expert viewpoints, and the particular lipid levels advised for distinct risk groups.
The Landmark Study of Dyslipidemia in India
Dyslipidemia, defined as abnormal lipid levels in the bloodstream, is a significant risk factor for strokes and heart attacks. A crucial study published in June 2023 in The Lancet Diabetes & Endocrinology found that dyslipidemia affects 81.2% of the Indian population. This large study, funded by ICMR and enrolling 113,043 individuals from October 2008 to December 2020, revealed the high prevalence of dyslipidemia in India. This frightening trend emphasizes the need for good management and early intervention plans.
Key Changes in the CSI Guidelines
The expert cardiologists of CSI slightly modified the conventional European recommendations and introduced the first-ever Indian guidelines after studying the findings of ICMR-INDIAB for four years.
The CSI recommendations propose to improve dyslipidemia management taking into account the unique characteristics of the Indian community such as the prevalence of lipid abnormalities and low HDL levels and lower the CVD burden in India. Two of the most important changes are the emphasis on genetic factors and the transition from traditional fasting to non-fasting lipid measures.
Focus on Genetic Factors
Genetics have an important influence on the development of dyslipidemia. Familial hypercholesterolemia, a hereditary disorder associated with elevated cholesterol levels, accounts for around 25% of dyslipidemia cases in India. Early detection of this illness via genetic screening is critical for effective intervention and therapy. Individuals having a family history of early heart disease or hypercholesterolemia should undergo genetic screening, according to CSI guidelines. This proactive strategy can aid in identifying at-risk persons early on and giving them appropriate treatment to avoid serious cardiovascular events.
Early Lipid Profiling
The CSI guidelines recommend the first lipid profile test at the age of 18. This early screening is important for people who have a family history of premature heart disease or hypercholesterolemia. Early identification enables proactive management and dramatically lowers the chance of developing serious CVD later in life. A novel modification in the guidelines is the transition from standard fasting tests to non-fasting lipid measurements for risk assessment and treatment. Non-fasting tests are more convenient, and safer, and allow for timely screening and follow-up treatment.
Recommended Lipid Levels for Different Risk Groups:
The CSI guidelines make precise recommendations for lipid levels based on individual risk assessment. These personalized ranges are intended to improve cardiovascular health while lowering the risk of heart attacks and strokes.
General Population and Low Risk:
Low-density lipoprotein Cholesterol (LDL-C) < 100 mg/dL
Non-HDL-C (Total Cholesterol minus HDL Cholesterol): <130 mg/dL
Individuals with diabetes or hypertension are at high risk:
LDL-C < 70 mg/dL
Non-HDL-C < 100 mg/dL
Individuals having a history of CVD, heart attacks, angina, stroke, or chronic kidney disease are at extremely high risk:
LDL-C < 55 mg/dL.
Non-HDL-C < 85 mg/dL
These guidelines are intended to keep lipid levels within safe limits, hence minimizing the risk of cardiovascular events.
The Transition to Non-Fasting Lipid Measurements
Traditionally, patients had to fast for 8-12 hours before taking lipid readings. This fasting restriction frequently presented difficulties, including difficulty and discomfort for patients, and could delay timely screening and follow-up. The CSI’s revised standards shift towards non-fasting lipid measurements, which have various advantages:
- Convenience: Patients can have lipid testing at any time of day without having to fast, making it easier to incorporate into regular health check-ups.
- Non-fasting tests are safer for diabetics who may get hypoglycemia (low blood sugar) as a result of extended fasting.
- Timeliness: Easier scheduling and faster turnaround times for tests and follow-up treatments enhance overall healthcare delivery.
Why Are Younger Indians at Higher Risk?
CSI experts have stated that cardiovascular disease risk factors appear approximately 10 years sooner in Indians than in Western cultures. Experts stated that over half of all heart attack patients in India are under 50 years old, with 15-20% under 40. These startling numbers highlight the critical need for awareness and early intervention.
Preventive measures for managing dyslipidemia
The CSI guidelines emphasize the value of preventative interventions in controlling dyslipidemia and lowering cardiovascular risk. These measures include the following:
- Genetic Screening: Early detection through genetic screening is critical for optimal management of familial hypercholesterolemia.
- Lifestyle Changes: A nutritious diet, regular exercise, and stress management are essential for maintaining normal lipid levels and overall heart health. Reducing sugar and carbohydrate intake is especially crucial in India, where they contribute more to heart blockages than moderate fat consumption.
- Medication: High-risk individuals should receive statins in addition to oral non-statin medicines. If these goals are not accomplished, injectable lipid-lowering medications such as PCSK9 inhibitors or Inclisiran are recommended.
Expert Opinions On The New Guidelines
CSI experts added, “Nearly 90% of these CVD cases are preventable if individuals are aware of their risk factors and work to keep their lipid levels within the recommended ranges.” They emphasized the significance of the transition to non-fasting measures, stating that it will improve the accessibility and efficiency of lipid profiling.
Conclusion
The new CSI guidelines mark a huge step forward in addressing India’s cardiovascular health crisis. These guidelines, which emphasize;
- The relevance of early lipid profiling,
- The convenience of non-fasting tests,
- The genetic screening and customized lipid ranges for various risk groups, aim to enhance dyslipidemia detection and management and improve their effectiveness.
We at Saaol Heart Care Delhi are committed to following these criteria in order to provide our patients with comprehensive and personalized care for heart blockage treatment. Early detection, preventive measures, and patient education are critical for maintaining heart health and lowering the burden of cardiovascular disease in India.
Visit our website to learn more about dyslipidemia management and heart health.