Cardiovascular Disease Risk Management in Diabetes – The Implications of the REALITY Asia Study

Assessment of Low-Density Lipoprotein Cholesterol (LDL-C) Goal Achievement Rate among Type 2 Diabetic Patients in Security Forces Hospital Diabetic Center, Riyadh, Saudi Arabia

“…While the association of uncontrolled LDL-C with advanced age was seen with Yan in REALITY Asia study, which found those with advancing age were highly associated with LDL-C goal achievement, it could be owing to many reasons such as different lifestyle and compliance to treatment. [28] Finally, the result of the association between uncontrolled DM and failure to achieve the LDL-C in our study is expected and supported by many of the studies as found with the same result in the study done by Hildemann et al [29]…”

Statin-centric versus low-density lipoprotein-centric approach for atherosclerotic cardiovascular disease prevention: a Singapore perspective

“…(17) Factors associated with a signifi cantly increased likelihood of goal attainment included advanced age and treatment with high-potency statins, whereas increased cardiovascular risk for CHD/diabetes mellitus at baseline (as compared with less than two risk factors) and baseline LDL-C levels were inversely associated with LDL-C goal achievement. (17) In Singapore, approximately 47% of patients used lowpotency statins, the majority of which were prescribed by general practitioners; of these patients, 45% required up-titration. (18) In particular, 40%-60% of diabetic patients required up-titration, but there was reluctance to up-titrate or switch to a higher dose or higher potency statin.…”

“…(11)(12)(13)(14)(15)(16) However, despite the reduction of LDL-C following statin therapy, residual cardiovascular risk remains high, as illustrated by the Return on Expenditure Achieved for Lipid Therapy in Asia (REALITY-Asia) study. (17) A retrospective cohort study conducted in China, Korea, Malaysia, Singapore, Taiwan and Thailand (comprising 437 physicians, 41% of whom were cardiologists), REALITY-Asia recruited adults with hypercholesterolaemia who were newly initiated on statin monotherapy in order to examine treatment patterns, goal attainment and factors infl uencing treatment. The study found that undertreatment of patients occurred mostly in the highestrisk group; high-risk individuals with established CHD/diabetes mellitus were least likely to achieve LDL-C targets (38% vs. 48% overall goal attainment).…”

“…Despite considerable baseline cardiovascular risk, 89% of patients received statins at low or moderate equipotent doses; the majority were using lowintensity statins. (17) The REALITY-Asia fi ndings highlighted the presence of statin phobia at the regional, country, physician and patient levels. (17) Factors associated with a signifi cantly increased likelihood of goal attainment included advanced age and treatment with high-potency statins, whereas increased cardiovascular risk for CHD/diabetes mellitus at baseline (as compared with less than two risk factors) and baseline LDL-C levels were inversely associated with LDL-C goal achievement.…”

“…(17) The REALITY-Asia fi ndings highlighted the presence of statin phobia at the regional, country, physician and patient levels. (17) Factors associated with a signifi cantly increased likelihood of goal attainment included advanced age and treatment with high-potency statins, whereas increased cardiovascular risk for CHD/diabetes mellitus at baseline (as compared with less than two risk factors) and baseline LDL-C levels were inversely associated with LDL-C goal achievement. (17) In Singapore, approximately 47% of patients used lowpotency statins, the majority of which were prescribed by general practitioners; of these patients, 45% required up-titration.…”