Published in the Journal of Diabetology | March–April 2026

In a significant step toward improving cardiovascular care in resource-limited settings, a recent study conducted at the Indus Hospital and Health Network (IHHN) highlights how simplifying lipid profile testing can make screening more accessible and affordable; without compromising clinical effectiveness.

The study was led by Dr. Faridah Amir Ali, alongside a dedicated team of researchers including Dr. Shaista Saghir, Dr. Imran Sheikhani, Dr. Nizahat Zehra, Dr. Bilal Tahir, and Dr. Abdul Basit. Their collective work brings forward practical, evidence-based solutions tailored to the healthcare realities of Pakistan.

Cardiovascular diseases (CVDs) continue to rise in countries like Pakistan, largely driven by dyslipidemia—an imbalance of lipids such as cholesterol and triglycerides in the blood. Despite the high burden, routine lipid screening remains limited due to cost constraints and lack of standardized protocols.

With nearly half of Pakistan’s adult population affected by hyperlipidemia, there is an urgent need to adopt smarter, cost-effective screening strategies that can reach a wider population.

This retrospective study analyzed data from over 27,000 adult patients who underwent lipid profile testing at IHHN’s Korangi campus in Karachi between 2021 and 2023. Researchers examined key lipid parameters including:

Total cholesterol
Low-density lipoprotein (LDL)
High-density lipoprotein (HDL)
Triglycerides (TG)
Non-HDL cholesterol
Low HDL was found to be the most common abnormality (76.3%), consistent with national data, but its clinical importance is limited. Despite earlier beliefs about its protective role, raising HDL has not shown cardiovascular benefit in trials, and current guidelines no longer recommend it as a treatment target. Therefore, routine HDL measurement may not be necessary, especially in resource-constrained settings.

LDL emerged as the most clinically relevant parameter. It showed strong correlations with total cholesterol and non-HDL cholesterol (r = 0.91, 0.90) respectively, and was highly prevalent, particularly among patients with diabetes and hypertension. LDL is a well-established, modifiable risk factor for cardiovascular disease, with strong evidence supporting its role in risk reduction through treatment. Current guidelines also prioritize LDL for initiating therapy.

Non-HDL cholesterol, while slightly broader in scope, closely mirrors LDL and does not add significant additional value in most cases, making LDL alone a reliable and practical marker.

Hypertriglyceridemia was less prevalent (18%) and triglycerides showed weaker correlations with other lipid parameters. Although important in certain conditions (e.g., severe elevations or metabolic syndrome), routine measurement is not essential. Testing can be reserved for high-risk or specific clinical scenarios.

Overall, the study supports a simplified screening approach prioritizing LDL and selectively including triglycerides can reduce costs and improve access in low-resource settings like Pakistan, without compromising clinical effectiveness.