Importance and Management of Non-High-Density Lipoprotein Cholesterol in Dyslipidemia Treatment

Area of Science:

• Cardiology
• Lipidology
• Public Health

Background:

• Residual cardiovascular risk persists despite statin therapy and low-density lipoprotein cholesterol (LDL-C) control.
• Non-high-density lipoprotein cholesterol (non-HDL-C) is a superior predictor of atherosclerotic cardiovascular disease (ASCVD) risk compared to LDL-C.
• Atherogenic dyslipidemia contributes significantly to residual cardiovascular risk.

Purpose of the Study:

• To develop evidence-based recommendations for adopting non-HDL-C as a lipid target in the Asia-Pacific (APAC) region.
• To provide practical guidance on managing non-HDL-C and cardiovascular risk in patients with atherogenic dyslipidemia.
• To address the gap in guideline recommendations for non-HDL-C as a primary lipid target in APAC.

Main Methods:

• A modified Delphi method was employed.
• Consensus was reached among 11 experts from 10 APAC countries.
• Evidence-based literature review informed the recommendations.

Main Results:

• The consensus document provides practical guidance for physicians on utilizing non-HDL-C as a therapeutic target.
• Recommendations include add-on therapies to statins for optimizing non-HDL-C reduction and mitigating CV risk.
• The guidance acknowledges and respects regional variations in lipid management within APAC.

Conclusions:

• Non-HDL-C should be considered a crucial target for managing cardiovascular risk in atherogenic dyslipidemia.
• Physicians in the APAC region are encouraged to integrate non-HDL-C management into clinical practice, aligning with local guidelines.
• This consensus aims to improve cardiovascular outcomes by optimizing lipid management beyond LDL-C alone.