India needs new cholesterol guidelines: Top cardiologist

With the growing rate of deaths due to heart disease, it is time for India to pro-actively consider new cholesterol guidelines for the future, top heart specialist Srinath Reddy said here Saturday.

"The early onset of heart disease in India, at the age 52, compared to China (63 years) and the US (62 years), makes India a unique ethnographic class when it comes to cholesterol guidelines," Reddy said.

Around the world, many countries have their own version of cholesterol guidelines to manage heart disease, with the focus being "what is the correct time to prescribe statins", he said.

Reddy is the president of the World Heart Federation and also the Public Health Foundation of India.

Statins are a group of medicines that can help lower the rates of the so-called 'bad cholesterol' in the blood by curbing production of low-density lipoprotein cholesterol in the liver, Reddy said.

International cholesterol guidelines have routinely liberalised the use of statin over the years, he added, speaking at a function to mark the 200,000th cardiac surgery at the prestigious Asian Heart Institute headed by Ramakanta Panda, here this evening.

For instance, the American Heart Association said in November 2013 that doctors should offer statin tablets to people having a 7.5 percent risk of developing heart diseases over a 10-year period and the British guidelines recommend 10 percent risk over the same time-frame.

However, India is a heavily diabetic nation and clinical trials indicate that statins are associated with excessive risk of diabetes occurrence among the patients, he said.

In view of this factor, Reddy said India would have to come up with its own set of guidelines on what is the right time to prescribe statins.

Emphasising the need for prevention better than cure, Panda said that reducing cholesterol levels, whether through medication or lifestyle changes, would lessen the risk of heart diseases.

"We must remember that taking statins should not replace 'living healthily' in the battle against heart disease," Panda said.

He referred to the WHO estimates of loss of productivity of $240 billion due to cardio-vascular diseases and said that better cholesterol guidelines would have to be supported by key public initiatives in India.

These include - reductions in risk factor levels like raising taxes on tobacco, percentage of salt in processed foods, banning smoking in public places, affordable drug therapy for those falling in the high risk category in the next ten years and a combination of population-based prevention-and-cure policy.

Indians have peculiarities like higher percentage of body fat mostly in the upper part, insulin resistance, prevalence of 'bad cholesterol', etc., for which a mix of better policy initiatives couple with diet, lifestyle and education to combat heart diseases are needed, Panda said.