Dyslipidaemia in Sri Lanka

Cardiovascular diseases (CVDs) are the leading cause of mortality in South Asia. Although well-recognized as a major risk factor, dyslipidemia in such populations is not well-reviewed. To review the trends in dyslipidemia, phenotypes, underlying causes, treatment modalities, and management gaps in Sri Lanka. A narrative review was undertaken on published literature on dyslipidemia in Sri Lanka from 2000 to 2020, extracted using PubMed, Google Scholar, and locally published literature. Out of the 33 documents reviewed, only a limited number was available on large-scale population-based studies. High prevalence of metabolic syndrome along with moderately high low-density lipoprotein-cholesterol, low high-density lipoprotein-cholesterol, high triglycerides, and high ApoB and Lp(a) concentrations was seen. Familial hypercholesterolemia was an understudied area with a need for a national screening program. With dyslipidemia guidelines limited to the management of special disease groups, there is a chasm between guidelines and practice at present in Sri Lanka. Unlike in primary prevention, prescribing high-dose statins in secondary prevention of CVD has been satisfactory. Treatment gaps are identified, with room for improvements in lipid screening and achieving lipid goals. Considering the substantial burden identified, education of physicians, optimizing lipid testing, and aggressive treatment of lipids are key initiatives toward optimizing management of dyslipidemia.