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.

Led by Prominent Researchers

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.

Addressing a Growing Health Burden

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.

A Large-Scale Study with Practical Insights

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

The goal was simple yet impactful: identify which of these markers truly matter for routine screening in low-resource settings.

Key Findings: LDL Takes the Lead

The study found that LDL cholesterol stands out as the most clinically relevant marker:

Strong correlation with total cholesterol (r = 0.91)
Strong correlation with non-HDL cholesterol (r = 0.90)
Significantly elevated in patients with diabetes and hypertension

These findings reinforce LDL’s central role in assessing cardiovascular risk and guiding treatment decisions.

What About HDL and Triglycerides?

Interestingly, HDL cholesterol, often labeled as “good cholesterol,” was the most frequently abnormal parameter—affecting over 76% of patients. However, the study found:

No strong causal link between HDL levels and cardiovascular outcomes
Limited therapeutic value, with no approved treatments specifically targeting HDL

Triglycerides (TG), on the other hand:

Were elevated in about 21% of patients
Showed higher relevance in individuals with diabetes and hypertension
Had weaker overall correlation with other lipid parameters

A Shift Toward Simplified Screening

Based on these findings, researchers propose a simplified lipid screening approach:

Prioritize LDL cholesterol as the primary marker
Include triglycerides selectively, especially in high-risk patients
De-emphasize routine HDL testing due to limited clinical utility

This approach can significantly reduce testing costs—currently ranging between Rs. 1900–2400—making screening more accessible for underserved populations.

Why This Matters

In a country where nearly 39% of the population lives in multidimensional poverty, and healthcare resources are stretched, such evidence-based simplifications can:

Expand access to essential diagnostics
Reduce financial burden on patients
Enable early detection and management of cardiovascular risks

Looking Ahead

While the study provides strong evidence for revising lipid screening protocols, the authors emphasize the need for multi-center and prospective studies to validate these findings and assess long-term outcomes.

Conclusion

This research offers a practical roadmap for low- and middle-income countries: focus on what matters most. By prioritizing LDL cholesterol and adopting a targeted approach to testing, healthcare systems can deliver more efficient, affordable, and impactful care—bringing us one step closer to better heart health for all.