Journal of Research in Medical Sciences (Jan 2024)

First Iranian guidelines for the diagnosis, management, and treatment of hyperlipidemia in adults

  • Fahimeh Bagheri Kholenjani,
  • Shahla Shahidi,
  • Golnaz Vaseghi,
  • Vahid Ashoorion,
  • Nizal Sarrafzadegan,
  • Mansour Siavash,
  • Maryam Heidarpour,
  • Shahrzad Shahidi,
  • Masoumeh Sadeghi,
  • Noushin Mohammadifard,
  • Masoumeh Jorjani,
  • Majid Ghayour Mobarhan,
  • Davood Shafie,
  • Hossein Farshidi,
  • Fariborz Khorvash,
  • Mojdeh Ghabaei,
  • Zahra Teimouri-Jervekani,
  • Mojgan Mortazavi,
  • Valiollah Hajhashemi,
  • Neda Roshanravan,
  • Leila Yazdanpanah,
  • Majid Davari,
  • Behzad Fatemi,
  • Elaheh Khorasani,
  • Ramesh Hoseinkhani,
  • Elaheh Zarean,
  • Alireza Ahmadi,
  • Maryam Eghbali Babadi,
  • Ahmadreza Assareh,
  • Mehdi Shadmani,
  • Javad Kojuri,
  • Farimah Shirani,
  • Mojgan Sanjari,
  • Fahimeh Haghighatdoost,
  • Razieh Hassannejad,
  • Elham Hashemi,
  • Mohammad Hassan Moaddab,
  • Alaleh Gheisari,
  • Bahar Dehghan,
  • Mitra Naseri,
  • Nosrat Ghaemi,
  • Fereidoun Noohi,
  • AliAkbar Haghdoost,
  • Amin Salehi-Abargouei,
  • Sara Beigrezaie,
  • Amin Doosti-Irani,
  • Nahid Ramezani-Jolfaie,
  • Bijan Eraj,
  • Mahin Hashemipour,
  • Ebrahim Nematipour,
  • Mahmoud Rafieian Kopaei

DOI
https://doi.org/10.4103/jrms.jrms_318_23
Journal volume & issue
Vol. 29, no. 1
pp. 18 – 18

Abstract

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This guideline is the first Iranian guideline developed for the diagnosis, management, and treatment of hyperlipidemia in adults. The members of the guideline developing group (GDG) selected 9 relevant clinical questions and provided recommendations or suggestions to answer them based on the latest scientific evidence. Recommendations include the low-density lipoprotein cholesterol (LDL-C) threshold for starting drug treatment in adults lacking comorbidities was determined to be over 190 mg/dL and the triglyceride (TG) threshold had to be >500 mg/dl. In addition to perform fasting lipid profile tests at the beginning and continuation of treatment, while it was suggested to perform cardiovascular diseases (CVDs) risk assessment using valid Iranian models. Some recommendations were also provided on lifestyle modification as the first therapeutic intervention. Statins were recommended as the first line of drug treatment to reduce LDL-C, and if its level was high despite the maximum allowed or maximum tolerated drug treatment, combined treatment with ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, or bile acid sequestrants was suggested. In adults with hypertriglyceridemia, pharmacotherapy with statin or fibrate was recommended. The target of drug therapy in adults with increased LDL-C without comorbidities and risk factors was considered an LDL-C level of <130 mg/dl, and in adults with increased TG without comorbidities and risk factors, TG levels of <200 mg/dl. In this guideline, specific recommendations and suggestions were provided for the subgroups of the general population, such as those with CVD, stroke, diabetes, chronic kidney disease, elderly, and women.

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