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Review
. 2024 Mar;76 Suppl 1(Suppl 1):S20-S28.
doi: 10.1016/j.ihj.2023.11.266. Epub 2024 Feb 12.

Trends in epidemiology of dyslipidemias in India

Sonali Sharma  1 , Kiran Gaur  2 , Rajeev Gupta  3
Affiliations
Review

Trends in epidemiology of dyslipidemias in India

Sonali Sharma et al. Indian Heart J. 2024 Mar.

Abstract

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

Keywords: Cholesterol; Dyslipidemias; Epidemiology; LDL cholesterol.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Geographic variations in prevalence of various dyslipidemias in different regions of India in the India Heart Watch. Definitions are-hypercholesterolemia ≥200 mg/dl, high LDL cholesterol ≥130 mg/dl, low HDL cholesterol <40 mg/dl in men and <50 mg/dl in women, and hypertriglyceridemia ≥150 mg/dl. Data source: India Heart Watch.,
Fig. 2
Fig. 2
State-level variation in the prevalence of various dyslipidemias in India. Definitions are-hypercholesterolemia ≥200 mg/dl, hypertriglyceridemia ≥150 mg/dl, high LDL cholesterol ≥130 mg/dl, low HDL cholesterol <40 mg/dl in men/<50 mg/dl in women. Data Source: ICMR-INDIAB study.
Fig. 3
Fig. 3
25-year trends in prevalence (percent) of various dyslipidemias in an urban Indian population in the Jaipur Heart Watch (JHW) studies. JHW-1 to JHW-6 from 1991 to 2015. Data source: Jaipur Heart Watch.,
Fig. 4
Fig. 4
Secular trends in mean total cholesterol, LDL cholesterol and NHDL cholesterol (in mmol/L) among men and women in India from 1980 to 2018. Data source: NCDRisC Report.
Fig. 5
Fig. 5
Population attributable fractions (percent) for various cardiovascular risk factors in the Prospective Urban Rural Epidemiology study shows raised NHDL cholesterol as the most important cardiovascular risk factor among South Asians. Data source: PURE Study.
See this image and copyright information in PMC

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