Need for hyperlipidemia management policy reform in China: learning from the global experience

Abstract

Objective: To evaluate the hyperlipidemia prevention programs and policies in different countries and highlight the need of reforming the hyperlipidemia prevention policies in China to lower the growing cardiovascular disease (CVD) risk.

Research design and methods: PubMed, Google Scholar and Cochrane were searched for global hyperlipidemia prevention policies. Government-funded policies pertaining to lipid management were considered for this review. Only those studies that evaluated the success of prevention policies on the basis of: (i) achievement of hyperlipidemia targets; (ii) improvement in Cardiovascular (CV) risk reduction; and (iii) outcomes with reduction in hyperlipidemia after implementation of the policy, were included.

Results: Several global policies and programs aimed to improve CV health by highlighting lipid profile management. Implementation of the global and national policies led to improvement in cholesterol related outcomes such as availability of diagnostic measures, awareness of the risk factors, decrease in cholesterol levels, achieving healthy lifestyle to prevent CVD and improvement in availability of hypolipidemic medications, etc. Statins have been covered under reimbursement policies in many countries to improve usage and thereby preventing incidence of stroke and CVD. We observed a need for introducing new programs in China as the ongoing hyperlipidemia management policies are inadequate. The World Bank Report 2016 recommended that prevention policies in China be modeled on the US Million Hearts program.

Conclusions: New hyperlipidemia prevention policies must set a time-bound target, and need to be patient and clinician centric in terms of applications, and revised periodically for long-term benefits.

Keywords:

• Hyperlipidemia
• cardiovascular diseases
• policy reform
• statins
• China

Transparency

Declaration of funding

This work received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Wei Yu^a, Ruizhi Shi^a, Jim Li^b, Yong Lan^a, Qian Li^a and Shanlian Hu^c

Declaration of financial/other relationships

W.Y., R.S., J.L., Y.L. and Q.L. have disclosed that they are employed by Pfizer. S.H. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

The authors acknowledge Mr. Karan Sharma (MPharm) and Dr. Amit Bhat (PhD), Indegene Pvt. Ltd., Bangalore, for providing medical writing support in preparation of the manuscript with funding from Pfizer, China.