International Atherosclerosis Society guidance for implementing best practice in the care of familial hypercholesterolaemia

Nature Reviews Cardiology, Journal Year: 2023, Volume and Issue: 20(12), P. 845 - 869

Published: June 15, 2023

Language: Английский

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World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update

Global Heart, Journal Year: 2024, Volume and Issue: 19(1)

Published: Jan. 1, 2024

Background: Secondary prevention lifestyle and pharmacological treatment of atherosclerotic cardiovascular disease (ASCVD) reduce a high proportion recurrent events mortality. However, significant gaps exist between guideline recommendations usual clinical practice. Objectives: Describe the state art, roadblocks, successful strategies to overcome them in ASCVD secondary management. Methods: A writing group reviewed guidelines research papers received inputs from an international committee composed health systems experts about article's structure, content, draft. Finally, external expert paper. Results: Smoking cessation, physical activity, diet weight management, antiplatelets, statins, beta-blockers, renin-angiotensin-aldosterone system inhibitors, cardiac rehabilitation Potential roadblocks may occur at individual, healthcare provider, levels include lack access medicines, inertia, primary care infrastructure or built environments that support preventive behaviours. Possible solutions improving literacy, self-management strategies, national policies improve medication (including fix-dose combination therapy), implementing programs, incorporating digital interventions. Digital tools are being examined range settings enhancing self-management, risk factor control, rehab. Conclusions: Effective for management exist, but there barriers their implementation. WHF roadmaps can facilitate development strategic plan identify implement local level approaches prevention.

Language: Английский

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The LDL cumulative exposure hypothesis: evidence and practical applications

Nature Reviews Cardiology, Journal Year: 2024, Volume and Issue: 21(10), P. 701 - 716

Published: July 5, 2024

Language: Английский

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Advancements in risk stratification and management strategies in primary cardiovascular prevention

Atherosclerosis, Journal Year: 2024, Volume and Issue: 395, P. 117579 - 117579

Published: May 15, 2024

Language: Английский

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Cardiovascular Disease in Saudi Arabia: facts and the way forward

Journal of the Saudi Heart Association, Journal Year: 2023, Volume and Issue: 35(2), P. 148 - 162

Published: July 26, 2023

Cardiovascular diseases (CVDs) remain a major health concern globally. While some risk factors for CVDs are non-modifiable, other determinants like obesity, hypertension, type-2 diabetes and dyslipidemia can be mitigated by wide plethora of measures to control CVD morbidity mortality. Those have been on the rise in Saudi Arabia, exacerbated sedentary lifestyle. The Vision 2030 aims reduce clinical economic burden scale up vitality longevity; new era comprehensive healthcare. From economics standpoint, entail healthcare systems directly through expenditure indirectly years living with disease, low productivity, premature This manuscript reviews current CV unmet needs discusses G20 countries' initiatives primary prevention: public measures, awareness programs; proposes national registries digital solutions facilitate population-specific research, improve surveillance alleviate Arabia.

Language: Английский

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Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

The Lancet, Journal Year: 2023, Volume and Issue: 403(10421), P. 55 - 66

Published: Dec. 12, 2023

Summary

Background

Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults were diagnosed before age 18 years via current diagnostic approaches, which derived from observations in adults. We aimed to characterise and adolescents heterozygous (HeFH) understand approaches the identification management inform future public health strategies.

Methods

For this cross-sectional study, we assessed younger than a clinical or genetic diagnosis HeFH at time entry into Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, Jan 31, 2021. Data collected 55 regional national registries 48 countries. Diagnoses relying on self-reported history suspected secondary excluded registry; people untreated LDL cholesterol (LDL-C) least 13·0 mmol/L study. overall by WHO region, World Bank country income status, age, criteria, index-case status. The main outcome study was assess hypercholesterolaemia.

Findings

Of 63 093 individuals FHSC registry, 11 848 (18·8%) included study; 5756 (50·2%) 476 female 5720 (49·8%) male. Sex data missing for 372 (3·1%) individuals. Median 9·6 (IQR 5·8–13·2). 10 099 (89·9%) 235 had final genetically confirmed 1136 (10·1%) diagnosis. Genetically 613 (5·2%) Genetic more common high-income countries (9427 [92·4%] 202) non-high-income (199 [48·0%] 415). 3414 (31·6%) 804 index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, disease uncommon, but 7557 (72·4%) 428 not taking lipid-lowering medication (LLM) median LDL-C 5·00 4·05–6·08). Compared diagnosis, use unadapted criteria intended reliant extreme phenotypes could result 50–75% being identified.

Interpretation

Clinical characteristics observed uncommon hypercholesterolaemia, hence detection group relies measurement confirmation. Where testing is unavailable, increased availability measurements first few life help reduce gap prevalence detection, enabling combination LLM reach recommended targets early life.

Funding

Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, Regeneron.

Language: Английский

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Trends in epidemiology of dyslipidemias in India

Indian Heart Journal, Journal Year: 2024, Volume and Issue: 76, P. S20 - S28

Published: Feb. 12, 2024

Dyslipidemias are the most important coronary artery disease (CAD) risk factor. High total cholesterol and its principal subtypes: low-density lipoprotein (LDL) non-high-density (NHDL) important. Epidemiological Mendelian randomization studies have confirmed role of raised triglycerides lipoprotein(a). INTERHEART study reported a significant association ApoB/ApoA1, total-, LDL-, NHDL-cholesterol in South Asians. Prospective Urban Rural Epidemiology (PURE) identified NHDL as Regional multisite epidemiological India increasing population levels triglycerides. Heart Watch higher prevalence LDL northern western Indian cities. ICMR-INDIAB regional variations hypercholesterolemia (≥200 mg/dl) from 4.6 % to 50.3 %, with greater states, Kerala, Goa, West Bengal. Non-Communicable Disease Risk Factor Collaboration Global Burden Diseases Studies LDL- India. among emigrant Indians UK USA compared Caucasians. Identification trends dyslipidemias need more nationwide surveys. needed assess quantum CAD incidence.

Language: Английский

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Cardiovascular Protective Properties of GLP-1 Receptor Agonists: More than Just Diabetic and Weight Loss Drugs

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(16), P. 4674 - 4674

Published: Aug. 9, 2024

Owing to their potent glucose-lowering efficacy and substantial weight loss effects, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are now considered part of the frontline therapeutic options treat both type 2 diabetes mellitus nondiabetic overweight/obesity. Stemming from successful demonstration cardiometabolic modulation reduction major adverse cardiovascular events in clinical outcome trials, GLP-1 RAs have since been validated as agents with compelling protective properties. Studies spanning bench preclinical large-scale randomised controlled trials consistently corroborated benefits this pharmacological class. Most notably, there is converging evidence that they exert favourable effects on atherosclerotic ischaemic endpoints, data indicating may do so by directly modifying burden composition plaques. This narrative review examines underlying pharmacology behind RAs, particular focus disease. It also delves into mechanisms underpin putative plaque-modifying actions, addresses existing knowledge gaps challenges looks future developments field, including use combination incretin for management.

Language: Английский

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Accuracy of 23 Equations for Estimating LDL Cholesterol in a Clinical Laboratory Database of 5,051,467 Patients

Global Heart, Journal Year: 2023, Volume and Issue: 18(1), P. 36 - 36

Published: June 19, 2023

Background: Alternatives to the Friedewald low-density lipoprotein cholesterol (LDL-C) equation have been proposed. Objective: To compare accuracy of available LDL-C equations with ultracentrifugation measurement. Methods: We used second harvest Very Large Database Lipids (VLDbL), which is a population-representative convenience sample adult and pediatric patients (N = 5,051,467) clinical lipid measurements obtained via vertical auto profile (VAP) method between October 1, 2015 June 30, 2019. performed systematic literature review identify compared their according guideline-based classification. also by median error versus ultracentrifugation. evaluated overall stratified age, sex, fasting status, triglyceride levels, as well in atherosclerotic cardiovascular disease, hypertension, diabetes, kidney inflammation, thyroid dysfunction. Results: Analyzing 23 identified 5,051,467 (mean±SD 56±16 years; 53.3% women), Martin/Hopkins most accurately classified correct category (89.6%), followed Sampson (86.3%), Chen (84.4%), Puavilai (84.1%), Delong (83.3%), (83.2%) equations. The other 17 were less accurate than Friedewald, low 35.1%. ranged from –10.8 18.7 mg/dL, was best optimized using (0.3, IQR–1.6 2.4 mg/dL). had highest after stratifying subgroups. In addition, one five who <70 almost half mg/dL levels 150–399 correctly reclassified >70 equation. Conclusions: Most proposed alternatives worsen accuracy, use could introduce unintended disparities care. demonstrated across

Language: Английский

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Lipid distributions in the Global Diagnostics Network across five continents

European Heart Journal, Journal Year: 2023, Volume and Issue: 44(25), P. 2305 - 2318

Published: July 1, 2023

Lipids are central in the development of cardiovascular disease, and present study aimed to characterize variation lipid profiles across different countries improve understanding risk opportunities for risk-reducing interventions.

Language: Английский

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