The Residual Risk Reduction Initiative: a call to action to reduce residual vascular risk in dyslipidaemic patients

Abstract

This position paper aims to highlight evidence that atherogenic dyslipidaemia contributes to residual macrovascular risk and microvascular complications despite current standards of care for dyslipidaemia and diabetes, and to recommend therapeutic intervention for reducing this, supported by evidence and expert consensus. Lifestyle modification is an important first step. Additionally, pharmacotherapy is often required. Adding niacin, a fibrate or omega-3 fatty acids to statin therapy improves achievement of all lipid risk factors. Outcomes studies are evaluating whether these strategies translate to greater clinical benefit than statin therapy alone. In conclusion, the R 3 i highlights the need to address with lifestyle and/or pharmacotherapy the high level of residual vascular risk among dyslipidaemic patients who are treated in accordance with current standards of care.

ESC/EAS Guidelines for the management of dyslipidaemias

“…However, the HDL-raising effect has been markedly less ( 5%) in the long-term intervention trials in people with type 2 diabetes 261,262 ; such differences appear to reflect distinctions in their relative binding affinities for PPARs, and notably for PPAR-a. 293 …”

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Wytyczne ESC dotyczące cukrzycy, stanu przedcukrzycowego i chorób układu sercowo- -naczyniowego opracowane we współpracy z EASD

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