2022 Saudi Guidelines for the Management of Dyslipidemia

AlRahimi, Jamilah; AlSaif, Shukri; Alasnag, Mirvat; Awan, Zuhier; Almutairi, Fawaz; Mudaiheem, H Al; Gencer, Baran; Catapano, Alberico L.; Mach, François; Tash, Adel

doi:10.4103/heartviews.heartviews_102_22

Cited by 3 publications

(2 citation statements)

References 143 publications

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“…Elevated low-density lipoprotein cholesterol (LDL-C) has been identified as a major risk factor for ASCVD, and attaining LDL-C treatment targets has successfully shown major cardiovascular (CV) risk and mortality reduction 7 . Therefore, LDL-C is considered the primary treatment target in all clinical practice guidelines for dyslipidemia management, which categorize CVD and adjust their treatment recommendations on the basis of LDL-C levels 8 – 10 . Moreover, LDL-C is a screening parameter for dyslipidemia among those with family history of genetic dyslipidemias, as well as chronic diseases with high CV risk 11 .…”

Section: Introductionmentioning

confidence: 99%

A novel equation for the estimation of low-density lipoprotein cholesterol in the Saudi Arabian population: a derivation and validation study

Nuwaylati,

Awan

2024

Sci Rep

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Low-density lipoprotein cholesterol (LDL-C) is typically estimated by the Friedewald equation to guide atherosclerotic cardiovascular disease (ASCVD) management despite its flaws. Martin–Hopkins and Sampson-NIH equations were shown to outperform Friedewald’s in various populations. Our aim was to derive a novel equation for accurate LDL-C estimation in Saudi Arabians and to compare it to Friedewald, Martin–Hopkins and Sampson-NIH equations. This is a cross-sectional study on 2245 subjects who were allocated to 2 cohorts; a derivation (1) and a validation cohort (2). Cohort 1 was analyzed in a multiple regression model to derive an equation (equationD) for estimating LDL-C. The agreement between the measured (LDL-CDM) and calculated levels was tested by Bland–Altman analysis, and the biases by absolute error values. Validation of the derived equation was carried out across LDL-C and triglyceride (TG)-stratified groups. The mean LDL-CDM was 3.10 ± 1.07 and 3.09 ± 1.06 mmol/L in cohorts 1 and 2, respectively. The derived equation is: LDL-CD = 0.224 + (TC × 0.919) – (HDL-C × 0.904) – (TG × 0.236) – (age × 0.001) – 0.024. In cohort 2, the mean LDL-C (mmol/L) was estimated as 3.09 ± 1.06 by equationD, 2.85 ± 1.12 by Friedewald, 2.95 ± 1.09 by Martin–Hopkins, and 2.93 ± 1.11 by Sampson-NIH equations; statistically significant differences between direct and calculated LDL-C was observed with the later three equations (P < 0.001). Bland–Altman analysis showed the lowest bias (0.001 mmol/L) with equationD as compared to 0.24, 0.15, and 0.17 mmol/L with Friedewald, Martin–Hopkins, and Sampson-NIH equations, respectively. The absolute errors in all guideline-stratified LDL-C categories was the lowest with equationD, which also showed the best classifier of LDL-C according to guidelines. Moreover, equationD predicted LDL-C levels with the lowest error with TG levels up to 5.63 mmol/L. EquationD topped the other equations in estimating LDL-C in Saudi Arabians as it could permit better estimation when LDL-C is < 2.4 mmol/L, in familial hyperlipidemia, and in hypertriglyceridemia, which improves cardiovascular outcomes in high-risk patients. We recommend further research to validate equationD in a larger dataset and in other populations.

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Section: Introductionmentioning

confidence: 99%

A novel equation for the estimation of low-density lipoprotein cholesterol in the Saudi Arabian population: a derivation and validation study

Nuwaylati,

Awan

2024

Sci Rep

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“…The cardiovascular risk assessment tools that have been used in the dyslipidemia guidelines were developed from cohorts in western societies that are very different from populations in other regions in the world, including the Middle East, thus limiting the generalizability of these risk estimation scores [ 20 ]. However, local experts in this region have developed risk score assessment tools that can be applied with confidence to tailor dyslipidemia therapy to each individual in the Middle East, including Jordan [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

A Jordanian Multidisciplinary Consensus Statement on the Management of Dyslipidemia

Al Mousa,

Al-Azzam,

Araydah

et al. 2023

JCM

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Atherosclerotic cardiovascular disease (ASCVD) is the primary contributor to global mortality rates, which significantly escalates healthcare expenditures. Risk factors for ASCVD (including dyslipidemia) frequently present in clusters rather than separately. Addressing these risk factors is crucial in the early initiation of a comprehensive management plan that involves both lifestyle modifications and pharmacotherapy to reduce the impact of ASCVD. A team of Jordanian professionals from various medical organizations and institutes took the initiative to create a set of guidelines for dyslipidemia screening and therapy. A detailed, comprehensive literature review was undertaken utilizing several databases and keywords. This consensus statement provides recommendations for dyslipidemia management in Jordanians on several issues including cardiovascular risk estimation, screening eligibility, risk categories, treatment goals, lifestyle changes, and statin and non-statin therapies. It is recommended that all Jordanian individuals aged 20 years old or older undergo lipid profile testing. This should be followed by determining the level of cardiovascular risk depending on the presence or absence of ASCVD and cardiovascular risk factors, eligibility for lipid-lowering therapy, and the target low-density cholesterol serum level to be achieved. In conclusion, prioritizing the management of dyslipidemia is of the utmost importance in improving public health and reducing the burden of cardiovascular diseases.

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Methodological quality and clinical recommendations of guidelines on the management of dyslipidaemias for cardiovascular disease risk reduction: a systematic review and an appraisal through AGREE II and AGREE REX tools

Deffert,

Vilela,

Cobre

et al. 2024

Family Practice

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Background Clinical practice guidelines (CPGs) are statements to assist practitioners and stakeholders in decisions about healthcare. Low methodological quality guidelines may prejudice decision-making and negatively affect clinical outcomes in non-communicable diseases, such as cardiovascular diseases worsted by poor lipid management. We appraised the quality of CPGs on dyslipidemia management and synthesized the most updated pharmacological recommendations. Methods A systematic review following international recommendations was performed. Searches to retrieve CPG on pharmacological treatments in adults with dyslipidaemia were conducted in PubMed, Scopus, and Trip databases. Eligible articles were assessed using AGREE II (methodological quality) and AGREE-REX (recommendation excellence) tools. Descriptive statistics were used to summarize data. The most updated guidelines (published after 2019) had their recommendations qualitatively synthesized in an exploratory analysis. Results Overall, 66 guidelines authored by professional societies (75%) and targeting clinicians as primary users were selected. The AGREE II domains Scope and Purpose (89%) and Clarity of Presentation (97%), and the AGREE-REX item Clinical Applicability (77.0%) obtained the highest values. Conversely, guidelines were methodologically poorly performed/documented (46%) and scarcely provided data on the implementability of practical recommendations (38%). Recommendations on pharmacological treatments are overall similar, with slight differences concerning the use of supplements and the availability of drugs. Conclusion High-quality dyslipidaemia CPG, especially outside North America and Europe, and strictly addressing evidence synthesis, appraisal, and recommendations are needed, especially to guide primary care decisions. CPG developers should consider stakeholders’ values and preferences and adapt existing statements to individual populations and healthcare systems to ensure successful implementation interventions.

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2022 Saudi Guidelines for the Management of Dyslipidemia

Cited by 3 publications

References 143 publications

A novel equation for the estimation of low-density lipoprotein cholesterol in the Saudi Arabian population: a derivation and validation study

A novel equation for the estimation of low-density lipoprotein cholesterol in the Saudi Arabian population: a derivation and validation study

A Jordanian Multidisciplinary Consensus Statement on the Management of Dyslipidemia

Methodological quality and clinical recommendations of guidelines on the management of dyslipidaemias for cardiovascular disease risk reduction: a systematic review and an appraisal through AGREE II and AGREE REX tools

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