Have a personal or library account? Click to login
Global Guidance for Dyslipidaemia Management in Adults: A Scoping Review Cover

Global Guidance for Dyslipidaemia Management in Adults: A Scoping Review

Global Heart
Volume 20 (2025): Issue 1
By: Andrew E. Moran,  Ashish Krishna,  Lawrence Mbuagbaw,  Kouamivi M. Aboyibor and  Rauell J. Santos  
Open Access
|Dec 2025

References

  1. 1Zheng J, Wang J, Zhang Y, Xia J, Guo H, Hu H, et al. The Global Burden of Diseases attributed to high low-density lipoprotein cholesterol from 1990 to 2019. Front Public Health. 2022;10:891929. DOI: 10.3389/fpubh.2022.891929
    Back to article
  2. 2World Health Organization. Global Health Observatory. World Health Organization. Accessed 14 November; 2024. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3236.
    Back to article
  3. 3Zhu JZ, Manne-Goehler J, Agarwal A, Bahendeka SK, Damasceno A, Marcus ME, et al. Medication use for cardiovascular disease prevention in 40 low- and middle-income countries. J Am Coll Cardiol. 2023;81(6):620–622. DOI: 10.1016/j.jacc.2022.12.003
    Back to article
  4. 4Marcus ME, Manne-Goehler J, Theilmann M, Farzadfar F, Moghaddam SS, Keykhaei M, et al. Use of statins for the prevention of cardiovascular disease in 41 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data. Lancet Glob Health. 2022;10(3):e369–e379. DOI: 10.1016/S2214-109X(21)00551-9
    Back to article
  5. 5World Health Organization. WHO handbook for guideline development. WHO; 2012. Accessed 27 December, 2024. https://www.who.int/publications/i/item/9789241548960.
    Back to article
  6. 6World Health Organization. World Health Organization non-communicable disease document repository. World Health Organization. Accessed 27 December, 2024. https://extranet.who.int/ncdccs/documents/Db.
    Back to article
  7. 7Pignone M. Low-density lipoprotein cholesterol-lowering therapy in the primary prevention of cardiovascular disease. In Connor RF, Wolters Kluwer (Eds.) UpToDate; Accessed March 25, 2025. https://www.uptodate.com/contents/low-density-lipoprotein-cholesterol-lowering-therapy-in-the-primary-prevention-of-cardiovascular-disease?search=Low-density%20lipoprotein%20cholesterol-lowering%20therapy%20in%20the%20primary%20prevention%20of%20cardiovascular%20disease&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1.
    Back to article
  8. 8Rosenson RS, Lopez-Sendon J. Management of low-density lipoprotein cholesterol (LDL-C) in the secondary prevention of cardiovascular disease. In Connor RF, Wolters Kluwer (Eds.) UpToDate. Accessed March 25, 2025. https://www.uptodate.com/contents/management-of-low-density-lipoprotein-cholesterol-ldl-c-in-the-secondary-prevention-of-cardiovascular-disease?search=Management%20of%20low-density%20lipoprotein%20cholesterol%20%28LDL-C%29%20in%20the%20secondary%20prevention%20of%20cardiovascular%20disease&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1.
    Back to article
  9. 9World Health Organization. Prevention of cardiovascular disease: guidelines for assessment and management of total cardiovascular risk. WHO; 2007. Accessed July 13, 2024. https://www.who.int/publications/i/item/9789241547178.
    Back to article
  10. 10World Health Organization. WHO package of essential noncommunicable (PEN) disease interventions for primary health care. WHO; 2020. Accessed December 27, 2024. https://www.who.int/publications/i/item/who-package-of-essential-noncommunicable-(pen)-disease-interventions-for-primary-health-care.
    Back to article
  11. 11World Health Organization. WHO updates cardiovascular risk charts. World Health Organisation. Accessed December 27, 2024. https://www.who.int/news/item/02-09-2019-who-updates-cardiovascular-risk-charts.
    Back to article
  12. 12Group WCRCW. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Glob Health. 2019;7(10):e1332–e1345. DOI: 10.1016/S2214-109X(19)30318-3
    Back to article
  13. 13World Health Organization. Guidelines for the management of dyslipidaemia in patients with diabetes mellitus: quick reference guide. WHO; 2006. Accessed December 27, 2024. https://www.emro.who.int/noncommunicable-diseases/publications/guidelines.html.
    Back to article
  14. 14World Health Organization. Diagnosis and management of Type 2 diabetes (HEARTS-D). WHO; 2020. Accessed 17 September 2024. https://www.who.int/publications/i/item/who-ucn-ncd-20.1.
    Back to article
  15. 15World Health Organization. Noncommunicable disease facility-based monitoring guidance: framework, indicators, and application. World Health Organization.
    Back to article
  16. 16World Health Organization. WHO Model List of Essential Medicines, 23rd List, 2023. WHO; 2023. Accessed November 19, 2023. https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2023.02.
    Back to article
  17. 17Patnode CD, Redmond N, Iacocca MO, Henninger M. Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2022;328(4):375–388. DOI: 10.1001/jama.2022.7408
    Back to article
  18. 18Cholesterol Treatment Trialists’ Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376(9753):1670–81. DOI: 10.1016/S0140-6736(10)61350-5
    Back to article
  19. 19Cholesterol Treatment Trialists’ Collaboration, Fulcher J, O’Connell R, Voysey M, Emberson J, Blackwell L, et al. Efficacy and safety of LDL-lowering therapy among men and women: meta-analysis of individual data from 174,000 participants in 27 randomised trials. Lancet. 2015;385(9976):1397–405. DOI: 10.1016/S0140-6736(14)61368-4
    Back to article
  20. 20Chou R, Dana T, Blazina I, Daeges M, Jeanne TL. Statins for prevention of cardiovascular disease in adults: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;316(19):2008–2024. DOI: 10.1001/jama.2015.15629
    Back to article
  21. 21Collins R, Reith C, Emberson J, Armitage J, Baigent C, Blackwell L, et al. Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet. 2016;388(10059):2532–2561. DOI: 10.1016/S0140-6736(16)31357-5
    Back to article
  22. 22de Lemos JA, Blazing MA, Wiviott SD, Lewis EF, Fox KAA, White HD, et al. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA. 2004;292(11):1307–16. DOI: 10.1001/jama.292.11.1307
    Back to article
  23. 23Newby LK, Kristinsson A, Bhapkar MV, Aylward PE, Dimas AP, Klein WW, et al. Early statin initiation and outcomes in patients with acute coronary syndromes. JAMA. 2002;287(23):3087–95. DOI: 10.1001/jama.287.23.3087
    Back to article
  24. 24Schwartz GG, Olsson AG, Ezekowitz MD, Ganz P, Oliver MF, Waters D, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA. 2001;285(13):1711–8. DOI: 10.1001/jama.285.13.1711
    Back to article
  25. 25Moran AE, Aimiosior O, Gupta R, Pathni A, Sahoo SK, Dessie G, et al. Integrated antihypertensive and statin treatment protocols for cardiovascular disease prevention in low- and middle-income countries. Glob Heart. 2024;19(1):93. DOI: 10.5334/gh.1376
    Back to article
  26. 26Koh N, Ference BA, Nicholls SJ, Navar AM, Chew DP, Kostner KM, et al. Asian Pacific Society of Cardiology Consensus Recommendations on Dyslipidaemia. Eur Cardiol. 2021;16:e54. DOI: 10.15420/ecr.2021.36
    Back to article
  27. 27Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111–188. DOI: 10.1093/eurheartj/ehz455
    Back to article
  28. 28Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies with the special contribution of the European Association of Preventive Cardiology (EAPC). Rev Esp Cardiol (Engl Ed). 2022;75(5):429. DOI: 10.1016/j.rec.2022.04.003
    Back to article
  29. 29Li JJ, Zhao SP, Zhao D, Lu GP, Peng DQ, Liu J, et al. 2023 Chinese guideline for lipid management. Front Pharmacol. 2023;14:1190934. DOI: 10.3389/fphar.2023.1190934
    Back to article
  30. 30Puri R, Bansal M, Mehta V, Dabla PK, Nanda R, Mohan JC, et al. Lipid association of India 2023 update on cardiovascular risk assessment and lipid management in Indian patients: consensus statement IV. J Clin Lipidol. 2024;18(3):e351–e373. DOI: 10.1016/j.jacl.2024.01.006
    Back to article
  31. 31Ministry of Health Sri Lanka. National Guideline for Management of Dyslipidaemia for Secondary and Tertiary Healthcare Level (Sri Lanka) [Internet]; 2021. www.health.gov.lk.
    Back to article
  32. 32Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1046–e1081. DOI: 10.1161/CIR.0000000000000624
    Back to article
  33. 33Pignone M, Phillips C, Mulrow C. Use of lipid lowering drugs for primary prevention of coronary heart disease: meta-analysis of randomised trials. BMJ. 2000;321(7267):983–6. DOI: 10.1136/bmj.321.7267.983
    Back to article
  34. 34Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366(9493):1267–78. DOI: 10.1016/S0140-6736(05)67394-1
    Back to article
  35. 35Ponce OJ, Larrea-Mantilla L, Hemmingsen B, Serrano V, Rodriguez-Gutierrez R, Spencer-Bonilla G, et al. Lipid-lowering agents in older individuals: a systematic review and meta-analysis of randomized clinical trials. J Clin Endocrinol Metab. 2019;104(5):1585–1594. DOI: 10.1210/jc.2019-00195
    Back to article
  36. 36Major RW, Cheung CK, Gray LJ, Brunskill NJ. Statins and cardiovascular primary prevention in CKD: a meta-analysis. Clin J Am Soc Nephrol. 2015;10(5):732–9. DOI: 10.2215/CJN.07460714
    Back to article
  37. 37Gami AS, Montori VM, Erwin PJ, Khan MA, Smith SA, Evidence in Diabetes Enquiry System Research G. Systematic review of lipid lowering for primary prevention of coronary heart disease in diabetes. BMJ. 2003;326(7388):528–9. DOI: 10.1136/bmj.326.7388.528
    Back to article
  38. 38Hou W, Lv J, Perkovic V, Yang L, Zhao N, Jardine MJ, et al. Effect of statin therapy on cardiovascular and renal outcomes in patients with chronic kidney disease: a systematic review and meta-analysis. Eur Heart J. 2013;34(24):1807–17. DOI: 10.1093/eurheartj/eht065
    Back to article
  39. 39Palmer SC, Craig JC, Navaneethan SD, Tonelli M, Pellegrini F, Strippoli GF. Benefits and harms of statin therapy for persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;157(4):263–75. DOI: 10.7326/0003-4819-157-4-201208210-00007
    Back to article
  40. 40Upadhyay A, Earley A, Lamont JL, Haynes S, Wanner C, Balk EM. Lipid-lowering therapy in persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;157(4):251–62. DOI: 10.7326/0003-4819-157-4-201208210-00005
    Back to article
  41. 41Navaneethan SD, Pansini F, Perkovic V, Manno C, Pellegrini F, Johnson DW, et al. HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis. Cochrane Database Syst Rev. 2009;(2):CD007784. DOI: 10.1002/14651858.CD007784
    Back to article
  42. 42Grinspoon SK, Fitch KV, Zanni MV, Fichtenbaum CJ, Umbleja T, Aberg JA, et al. Pitavastatin to prevent cardiovascular disease in HIV infection. N Engl J Med. 2023;389(8):687–699. DOI: 10.1056/NEJMoa2304146
    Back to article
  43. 43de Vries FM, Denig P, Pouwels KB, Postma MJ, Hak E. Primary prevention of major cardiovascular and cerebrovascular events with statins in diabetic patients: a meta-analysis. Drugs. 2012;72(18):2365–73. DOI: 10.2165/11638240-000000000-00000
    Back to article
  44. 44Cholesterol Treatment Trialists’ Collaborators, Kearney PM, Blackwell L, Collins R, Keech A, Simes J, et al. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet. 2008;371(9607):117–25. DOI: 10.1016/S0140-6736(08)60104-X
    Back to article
  45. 45Cholesterol Treatment Trialists’ Collaboration. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet. 2019;393(10170):407–415. DOI: 10.1016/S0140-6736(18)31942-1
    Back to article
  46. 46Gencer B, Marston NA, Im K, Cannon CP, Sever P, Keech A, et al. Efficacy and safety of lowering LDL cholesterol in older patients: a systematic review and meta-analysis of randomised controlled trials. Lancet. 2020;396(10263):1637–1643. DOI: 10.1016/S0140-6736(20)32332-1
    Back to article
  47. 47Cholesterol Treatment Trialists’ Collaborators, Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581–90. DOI: 10.1016/S0140-6736(12)60367-5
    Back to article
  48. 48Karmali KN, Persell SD, Perel P, Lloyd-Jones DM, Berendsen MA, Huffman MD. Risk scoring for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2017;3(3):CD006887. DOI: 10.1002/14651858.CD006887.pub4
    Back to article
  49. 49Hsu HY, Lin CJ, Lee YS, Wu TH, Chien KL. Efficacy of more intensive lipid-lowering therapy on cardiovascular diseases: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2020;20(1):334. DOI: 10.1186/s12872-020-01567-1
    Back to article
  50. 50Josan K, Majumdar SR, McAlister FA. The efficacy and safety of intensive statin therapy: a meta-analysis of randomized trials. CMAJ. 2008;178(5):576–84. DOI: 10.1503/cmaj.070675
    Back to article
  51. 51Chan DK, O’Rourke F, Shen Q, Mak JC, Hung WT. Meta-analysis of the cardiovascular benefits of intensive lipid lowering with statins. Acta Neurol Scand. 2011;124(3):188–95. DOI: 10.1111/j.1600-0404.2010.01450.x
    Back to article
  52. 52Blasetto JW, Stein EA, Brown WV, Chitra R, Raza A. Efficacy of rosuvastatin compared with other statins at selected starting doses in hypercholesterolemic patients and in special population groups. Am J Cardiol. 2003;91(5A):3C–10C; discussion 10C. DOI: 10.1016/s0002-9149(03)00003-1
    Back to article
  53. 53Smilde TJ, van Wissen S, Wollersheim H, Trip MD, Kastelein JJ, Stalenhoef AF. Effect of aggressive versus conventional lipid lowering on atherosclerosis progression in familial hypercholesterolaemia (ASAP): a prospective, randomised, double-blind trial. Lancet. 2001;357(9256):577–81. DOI: 10.1016/s0140-6736(00)04053-8
    Back to article
  54. 54Koskinas KC, Siontis GCM, Piccolo R, Mavridis D, Räber L, Mach F, et al. Effect of statins and non-statin LDL-lowering medications on cardiovascular outcomes in secondary prevention: a meta-analysis of randomized trials. Eur Heart J. 2018;39(14):1172–1180. DOI: 10.1093/eurheartj/ehx566
    Back to article
  55. 55Hosseini K, Soleimani H, Maleki S, Nasrollahizadeh A, Tayebi S, Nelson J, et al. Early administration of proprotein convertase subtilisin/kexin Type 9 (PCSK9) inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2024;24(1):395. DOI: 10.1186/s12872-024-04057-w
    Back to article
  56. 56Wu XD, Ye XY, Liu XY, Lin Y, Lin X, Li YY, et al. Benefits of intensive lipid-lowering therapies in patients with acute coronary syndrome: a systematic review and meta-analysis. Ann Med. 2024;56(1):2389470. DOI: 10.1080/07853890.2024.2389470
    Back to article
  57. 57Wang X, Zhang Y, Tan H, Wang P, Zha X, Chong W, et al. Efficacy and safety of bempedoic acid for prevention of cardiovascular events and diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol. 2020;19(1):128. DOI: 10.1186/s12933-020-01101-9
    Back to article
  58. 58Sayed A, Shazly O, Slipczuk L, Krittanawong C, Baloch F, Virani SS. The clinical efficacy and safety of bempedoic acid in patients at elevated risk of cardiovascular disease: a meta-analysis of randomized clinical trials. Cardiovasc Drugs Ther. 2024;38(6):1415–1420. DOI: 10.1007/s10557-023-07474-9
    Back to article
  59. 59Sydhom P, Al-Quraishi B, El-Shawaf M, Osman MT, Naji N, Awwad N, et al. The clinical effectiveness and safety of low/moderate-intensity statins & ezetimibe combination therapy vs. high-intensity statin monotherapy: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2024;24(1):660. DOI: 10.1186/s12872-024-04144-y
    Back to article
  60. 60Navarese EP, Kolodziejczak M, Schulze V, Gurbel PA, Tantry U, Lin Y, et al. Effects of proprotein convertase subtilisin/kexin Type 9 antibodies in adults with hypercholesterolemia: a systematic review and meta-analysis. Ann Intern Med. 2015;163(1):40–51. DOI: 10.7326/M14-2957
    Back to article
  61. 61Savarese G, De Ferrari GM, Rosano GM, Perrone-Filardi P. Safety and efficacy of ezetimibe: a meta-analysis. Int J Cardiol. 2015;201:247–52. DOI: 10.1016/j.ijcard.2015.08.103
    Back to article
  62. 62Du H, Li X, Su N, Li L, Hao X, Gao H, et al. Proprotein convertase subtilisin/kexin 9 inhibitors in reducing cardiovascular outcomes: a systematic review and meta-analysis. Heart. 2019;105(15):1149–1159. DOI: 10.1136/heartjnl-2019-314763
    Back to article
  63. 63Imran TF, Khan AA, Has P, Jacobson A, Bogin S, Khalid M, et al. Proprotein convertase subtilisn/kexin Type 9 inhibitors and small interfering RNA therapy for cardiovascular risk reduction: a systematic review and meta-analysis. PLoS One. 2023;18(12):e0295359. DOI: 10.1371/journal.pone.0295359
    Back to article
  64. 64Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, et al. PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020;10(10):CD011748. DOI: 10.1002/14651858.CD011748.pub3
    Back to article
  65. 65Toth PP, Bray S, Villa G, Palagashvili T, Sattar N, Stroes ESG, et al. Network meta-analysis of randomized trials evaluating the comparative efficacy of lipid-lowering therapies added to maximally tolerated statins for the reduction of low-density lipoprotein cholesterol. J Am Heart Assoc. 2022;11(18):e025551. DOI: 10.1161/JAHA.122.025551
    Back to article
  66. 66Perez de Isla L, Diaz-Diaz JL, Romero MJ, Muñiz-Grijalvo O, Mediavilla JD, Argüeso R, et al. Alirocumab and coronary atherosclerosis in asymptomatic patients with familial hypercholesterolemia: the ARCHITECT study. Circulation. 2023;147(19):1436–1443. DOI: 10.1161/CIRCULATIONAHA.122.062557
    Back to article
  67. 67Shepherd J, Hunninghake DB, Barter P, McKenney JM, Hutchinson HG. Guidelines for lowering lipids to reduce coronary artery disease risk: a comparison of rosuvastatin with atorvastatin, pravastatin, and simvastatin for achieving lipid-lowering goals. Am J Cardiol. 2003;91(5A):11C–17C. DOI: 10.1016/s0002-9149(03)00004-3
    Back to article
  68. 68Jones P, Kafonek S, Laurora I, Hunninghake D. Comparative dose efficacy study of atorvastatin versus simvastatin, pravastatin, lovastatin, and fluvastatin in patients with hypercholesterolemia (the CURVES study). Am J Cardiol. 1998;81(5):582–7. DOI: 10.1016/s0002-9149(97)00965-x
    Back to article
  69. 69Rosenson RS. Rosuvastatin: a new inhibitor of HMG-coA reductase for the treatment of dyslipidemia. Expert Rev Cardiovasc Ther. 2003;1(4):495–505. DOI: 10.1586/14779072.1.4.495
    Back to article
DOI: https://doi.org/10.5334/gh.1506 | Journal eISSN: 2211-8179
Journal RSS Feed
Language: English
Submitted on: Aug 2, 2025
Accepted on: Dec 1, 2025
Published on: Dec 16, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
World Health Organisation,
Lipid lowering therapy,
Dyslipidaemia,
Guidelines,
Scoping Review

© 2025 Andrew E. Moran, Ashish Krishna, Lawrence Mbuagbaw, Kouamivi M. Aboyibor, Rauell J. Santos, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Previous articleVolume 20 (2025): Issue 1