Academic Journal

Are Current Lipid Guidelines Adequate for South Asian Patients? A Narrative Review.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Are Current Lipid Guidelines Adequate for South Asian Patients? A Narrative Review.
Συγγραφείς: Fernando K; Medical Research Institute, Borella, Sri Lanka.; NK Ceylon Institute of Medical Research, Negombo, Sri Lanka., De Silva S; Faculty of Medicine, University of Kelaniya, Sri Lanka.; Colombo North Teaching Hospital, Ragama, Sri Lanka.
Πηγή: Global heart [Glob Heart] 2026 Oct 08; Vol. 21 (1), pp. 72. Date of Electronic Publication: 2026 Oct 08 (Print Publication: 2026).
Τύπος έκδοσης: Journal Article; Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Ubiquity Press Country of Publication: England NLM ID: 101584391 Publication Model: eCollection Cited Medium: Internet ISSN: 2211-8179 (Electronic) Linking ISSN: 22118160 NLM ISO Abbreviation: Glob Heart Subsets: MEDLINE
Imprint Name(s): Publication: 2020- : [London] : Ubiquity Press
Original Publication: [Oxford] : Elsevier Ltd.
Ιατρικοί όροι (MeSH): Cardiovascular Diseases*/ethnology , Cardiovascular Diseases*/blood , Cardiovascular Diseases*/prevention & control , Lipids*/blood , Practice Guidelines as Topic*, Risk Assessment/methods ; Humans ; South Asian People ; Asia, Southern
Περίληψη: South Asians, who account for nearly one quarter of the world's population, experience a disproportionately high burden of atherosclerotic cardiovascular disease (ASCVD), often presenting 5-10 years earlier than European populations. This review evaluates whether contemporary lipid-management frameworks adequately address cardiovascular risk in South Asians. South Asians exhibit a distinct lipid phenotype characterised by elevated apolipoprotein B (ApoB), hypertriglyceridaemia, reduced HDL-cholesterol (HDL-C), increased small dense LDL (sdLDL) particles, and a high prevalence of elevated lipoprotein(a) (Lp(a)), features that are incompletely captured by conventional LDL-cholesterol (LDL-C)-based approaches. Existing cardiovascular risk tools show variable performance in South Asian populations, while contemporary guidelines differ substantially in risk assessment, LDL-cholesterol targets, incorporation of risk enhancers, and use of coronary artery calcium (CAC) scoring. Although recent guideline updates increasingly acknowledge South Asian ethnicity as a risk modifier, important gaps in calibration and implementation remain. Greater harmonisation of recommendations and validation of South Asian-specific risk assessment strategies are needed to improve cardiovascular prevention.
(Copyright: © 2026 The Author(s).)
Competing Interests: The authors have no competing interests to declare.
References: Lancet. 2008 Jul 19;372(9634):224-33. (PMID: 18640459)
JACC Asia. 2024 Mar 19;4(4):275-278. (PMID: 38660105)
Indian Heart J. 2024 May-Jun;76(3):154-158. (PMID: 38871221)
JACC Asia. 2025 Oct;5(10):1244-1256. (PMID: 40817904)
Cardiol Res Pract. 2012;2012:658526. (PMID: 22111029)
Curr Probl Cardiol. 2021 Mar;46(3):100581. (PMID: 32295712)
Prog Cardiovasc Dis. 2022 Nov-Dec;75:21-32. (PMID: 36279943)
Acta Pharmacol Sin. 2011 Jan;32(1):116-25. (PMID: 21151159)
BMC Cardiovasc Disord. 2022 Dec 23;22(1):566. (PMID: 36564709)
J Am Heart Assoc. 2020 Feb 4;9(3):e013600. (PMID: 32013698)
Atherosclerosis. 2020 Nov;313:14-19. (PMID: 33002750)
PLoS One. 2014 Aug 12;9(8):e102645. (PMID: 25115870)
Clin Pharmacol Ther. 2005 Oct;78(4):330-41. (PMID: 16198652)
Eur Heart J. 2025 Nov 7;46(42):4359-4378. (PMID: 40878289)
Circulation. 2019 Jun 18;139(25):e1082-e1143. (PMID: 30586774)
J Am Heart Assoc. 2025 Jul 15;14(14):eJAHA2024040361T. (PMID: 40654252)
J Clin Lipidol. 2025 Jul-Aug;19(4):844-859. (PMID: 40681368)
Am J Prev Cardiol. 2022 Dec 23;13:100453. (PMID: 36636125)
Am J Cardiol. 2007 Jun 1;99(11):1538-43. (PMID: 17531577)
Curr Probl Cardiol. 2023 Apr;48(4):101105. (PMID: 34999157)
Eur Heart J. 2025 May 2;46(17):1682-1684. (PMID: 39964347)
Heart. 2014 Jan;100(1):60-7. (PMID: 24186564)
Egypt Heart J. 2026 May 18;78(1):. (PMID: 42149392)
JACC Asia. 2026 Aug;6(8 Pt 2):1627-1645. (PMID: 41712894)
Diabetes Technol Ther. 2011 Jun;13(6):683-94. (PMID: 21488798)
Curr Cardiovasc Risk Rep. 2019 Aug;13(8):. (PMID: 33833849)
Lipids Health Dis. 2025 Dec 09;25(1):13. (PMID: 41366390)
Glob Heart. 2021 Jan 20;16(1):7. (PMID: 33598387)
J Clin Lipidol. 2024 May-Jun;18(3):e351-e373. (PMID: 38485619)
Circulation. 2023 Aug 15;148(7):e5. (PMID: 37579012)
Cardiol Rev. 2020 Sep/Oct;28(5):250-255. (PMID: 31688091)
Sci Rep. 2026 Feb 28;16(1):. (PMID: 41764281)
Ann N Y Acad Sci. 2021 Jul;1495(1):24-39. (PMID: 33216378)
J Am Coll Cardiol. 2009 Jan 20;53(3):244-53. (PMID: 19147041)
Circulation. 2019 Sep 10;140(11):e596-e646. (PMID: 30879355)
Curr Atheroscler Rep. 2023 Jul;25(7):359-372. (PMID: 37233946)
Eur Heart J. 2020 Jan 1;41(1):111-188. (PMID: 31504418)
J Clin Lipidol. 2021 May-Jun;15(3):402-422. (PMID: 33846108)
Lancet Glob Health. 2019 Oct;7(10):e1332-e1345. (PMID: 31488387)
Heart. 2023 Oct 26;109(22):1690-1697. (PMID: 37423742)
J Am Coll Cardiol. 2026 May 19;87(19):2624-2757. (PMID: 41824590)
World J Cardiol. 2016 Mar 26;8(3):247-57. (PMID: 27022456)
Contributed Indexing: Keywords: PREVENT equations; South Asian; apolipoprotein B; cardiovascular risk; coronary artery calcium; lipid guidelines; lipoprotein(a); risk stratification
Substance Nomenclature: 0 (Lipids)
Entry Date(s): Date Created: 20261010 Date Completed: 20261010 Latest Revision: 20261013
Update Code: 20261013
PubMed Central ID: PMC13651774
DOI: 10.5334/gh.1590
PMID: 42857687
Βάση Δεδομένων: MEDLINE