Nasreen Al Sayed, Khalid Al Waili, Fatheya Alawadi,Saeed Al-Ghamdi, Wael Al Mahmeed, Fahad Al-Nouri, Mona Al Rukhaimi, Khalid Al-Rasadi, Zuhier Awan, Mohamed Farghaly, Mohamed Hassanein, Hani Sabbour, Mohammad Zubaid, Philip Barter

a. Gulf Diabetes Specialist Center, P.O. Box 21686, Manama, Bahrain
b. Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Al-Khod, P.O. Box 38, postal code 123, Muscat, Oman
c. Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
d. Department of Medicine, King Abdulaziz University Hospital, P.O. Box 80215, Jeddah 21589, Saudi Arabia
e. Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
f. Cardiovascular Prevention Unit, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
g. Dubai Medical College, P.O. Box 22331, Dubai, United Arab Emirates
h. Department of Biochemistry, Sultan Qaboos University Hospital, Al-Khod, P.O. Box 38, postal code 123, Muscat, Oman
i. King Abdulaziz University, Jeddah 22254, Saudi Arabia
j. Dubai Medical College, Dubai, United Arab Emirates
k. Dubai Hospital, Dubai, United Arab Emirates
l. Shaikh Khalifa Medical City, Cardiac Sciences Institute, Abu Dhabi, United Arab Emirates
m. Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait n School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia

Background:

Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease
(ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no regionspecific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions.
Methods: A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East. The panel considered existing international guidelines
and regional clinical experience to develop recommendations.
Results: The panel’s recommendations include plasma lipid screening, ASCVD risk calculation and treatment considerations. The panel recommend that plasma lipid levels should be measured in all at-risk patients and at regular intervals in all adults from the age of 20 years. A scoring system should be used to calculate ASCVD risk that includes
known lipid and non-lipid risk factors. Primary treatment targets include low-density lipoprotein cholesterol and
non-high-density lipoprotein cholesterol. Lifestyle modifications should be first-line treatment for all patients; the
first-line pharmacological treatment targeting plasma lipids in patients at moderate-to-high risk of ASCVD is statin
therapy, with a number of adjunctive or second-line agents available. Guidance is also provided on the management
of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia.

Conclusions:
These consensus clinical recommendations provide practicing clinicians with comprehensive, regionspecific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East.
© 2016 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-ND