title: Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East.
abstract: 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 region-specific 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 20years. 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, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East.
authors.affiliation: Gulf Diabetes Specialist Center, P.O. Box 21686, Manama, Bahrain. Electronic address: nasreen.alsayed@gulfdiabetes.com.
authors.forename: Nasreen
authors.initials: N
authors.lastname: Al Sayed
authors.affiliation: Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Al-Khod, P.O. Box 38, postal code 123, Muscat, Oman. Electronic address: khalidalwaili@hotmail.com.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Waili
authors.affiliation: Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates. Electronic address: ffalawadi@dha.gov.ae.
authors.forename: Fatheya
authors.initials: F
authors.lastname: Alawadi
authors.affiliation: Department of Medicine, King Abdulaziz University Hospital, P.O. Box 80215, Jeddah 21589, Saudi Arabia. Electronic address: smghamdi@kfshrc.edu.sa.
authors.forename: Saeed
authors.initials: S
authors.lastname: Al-Ghamdi
authors.affiliation: Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates. Electronic address: wmahmeed@gmail.com.
authors.forename: Wael
authors.initials: W
authors.lastname: Al Mahmeed
authors.affiliation: Cardiovascular Prevention Unit, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. Electronic address: fahad@alnouri.net.
authors.forename: Fahad
authors.initials: F
authors.lastname: Al-Nouri
authors.affiliation: Dubai Medical College, P.O. Box 22331, Dubai, United Arab Emirates. Electronic address: mona_539@yahoo.co.uk.
authors.forename: Mona
authors.initials: M
authors.lastname: Al Rukhaimi
authors.affiliation: Department of Biochemistry, Sultan Qaboos University Hospital, Al-Khod, P.O. Box 38, postal code 123, Muscat, Oman. Electronic address: k.alrasadi@gmail.com.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Rasadi
authors.affiliation: King Abdulaziz University, Jeddah 22254, Saudi Arabia. Electronic address: zawan@kau.edu.sa.
authors.forename: Zuhier
authors.initials: Z
authors.lastname: Awan
authors.affiliation: Dubai Medical College, Dubai, United Arab Emirates. Electronic address: mnFargaly@dha.gov.ae.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Farghaly
authors.affiliation: Dubai Hospital, Dubai, United Arab Emirates. Electronic address: mhassanein148@hotmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassanein
authors.affiliation: Shaikh Khalifa Medical City, Cardiac Sciences Institute, Abu Dhabi, United Arab Emirates. Electronic address: hanisabbour1@icloud.com.
authors.forename: Hani
authors.initials: H
authors.lastname: Sabbour
authors.affiliation: Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait. Electronic address: zubaid@HSC.EDU.KW.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zubaid
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: pbarter@ozemail.com.au.
authors.forename: Philip
authors.initials: P
authors.lastname: Barter
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016022:Case-Control Studies; D019468:Disease Management; D050171:Dyslipidemias / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008877:Middle East / Q000453:epidemiology; D017410:Practice Guidelines as Topic / Q000592:standards*; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents
keywords: Cardiovascular disease; Dyslipidaemia; Guidelines; Lipid disorder; Middle East