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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #8 2024

SPECIAL POPULATIONS – WOMEN OF REPRODUCTIVE AGE Dyslipidaemia

Dyslipidemia management in women of reproductive potential: An expert clinical

consensus from the national lipid association.
Agarwala A, et al. J Clin Lipidol. 2024 May 30:S1933-2874(24)00188-0.

CVD is the leading cause of death in women, and rates are increasing among younger women. This alarming trend underscores
the need for effective prevention and management strategies starting early in life. Despite the established benefits of lipid-lowering
therapy, women, especially young women, are less likely to receive treatment and achieve their LDL-C targets.

The National Lipid Association has released an expert clinical consensus statement focused on the dyslipidaemia management
in women of reproductive potential. They present a comprehensive review of the latest guidelines and evidence-based
recommendations for managing dyslipidemia in women during preconception, pregnancy, and lactation. The consensus statement
emphasizes the significance of lifestyle interventions, including nutrition and physical activity, and explores the safety and efficacy of
various pharmacological therapies for managing dyslipidemia, particularly during pregnancy.

With regards to lifestyle, nutrition, and physical activity, the National Lipid Association recommends that women of reproductive
age follow a heart healthy dietary pattern that limits the intake of saturated and trans fats, processed foods, and added sugars, and
prioritizes fruits, vegetables, whole grains, and lean protein sources. It is also recommended to engage in at least 150 minutes per
week of moderate-to-vigorous intensity physical activity, including resistance exercises twice per week. During pregnancy, caloric
intake should be adjusted to meet the Institute of Medicine’s weight gain recommendations based on prepregnancy BMI, and women
should be encouraged to continue physical activity as long as no contraindications are present. Post-partum, a 5%–10% weight loss
can improve lipid levels, and pharmacotherapy with GLP-1 receptor agonists can be considered for weight management in those who
have not achieved adequate weight loss with lifestyle interventions alone.

Pregnancy significantly impacts Lipoprotein lipid levels before, during, and after pregnancy
lipid levels, with increases in
TC, LDL-C, TG, and Lp(a). TC,
LDL-C and TG levels all show
an upward trend throughout
pregnancy, peaking in the third
trimester, before declining in
the postpartum period. HDL-C
levels remain relatively stable
throughout pregnancy and the
early postpartum period. These
changes can pose potential CV
risks for women with pre-existing
dyslipidaemia or those who
develop gestational dyslipidaemia.
This emphasizes the importance
of monitoring lipid levels during
pregnancy and postpartum and
implementing appropriate lifestyle
and medical interventions to
mitigate potential risks.

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