Consensus Statements on Dyslipidemia in Indian Women

Dyslipidemia is a major, yet under-recognized, driver of atherosclerotic cardiovascular disease (ASCVD) in Indian women. This expert consensus provides India-specific guidance on early detection, risk stratification, and management of lipid disorders across the female life course. Seventy-five specialists from cardiology, endocrinology, lipidology, obstetrics–gynecology, and primary care participated in a modified Delphi process with three structured rounds. An agreement threshold of ≥80% was maintained to develop statements based on 20 key clinical questions and a comprehensive review of international and Indian evidence. The consensus emphasizes early and repeated lipid screening. All women should have at least one lipid profile between ages 20 and 39 years, with earlier and more frequent testing in those with a family history of premature ASCVD, suspected familial hypercholesterolemia, polycystic ovary syndrome, gestational diabetes, pre-eclampsia, premature menopause, or autoimmune disorders. Life-stage checkpoints such as pre-conception, 6–12 weeks postpartum, and at menopause are highlighted as critical opportunities for evaluation and intervention. The panel developed India-specific, life-stage-oriented risk assessment and management statements for women, emphasizing early lipid screening, recognition of female-specific risk enhancers, and practical treatment pathways. Management begins with lifestyle optimization and, when indicated, stepwise pharmacotherapy: Statins as first line (avoiding routine use in pregnancy and lactation), ezetimibe or fibrates as add-on therapy, and PCSK9 inhibitors or Inclisiran for very-high-risk cases not at target. Bile-acid sequestrants are identified as the safest drug option during pregnancy or breastfeeding. This statement integrates global best practice with India-specific risk profiles and care pathways. By embedding life-stage-oriented screening, female-specific risk enhancers, and risk stratification into routine care, it provides a practical roadmap for clinicians and public health programs to reduce the burden of ASCVD in Indian women.