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Experts bring risk reduction to Ireland

A group of specialists has brought the international Residual Risk Reduction initiative (R3i) to this country in a bid to address the ‘disconcerting rates’ of macrovascular events and microvascular complications among Irish patients.

Co-chaired by Dr Maeve Durkan, Consultant in Diabetes and Endocrinology, Portiuncula Hospital, Ballinasloe, and Dr Vincent Maher, Consultant Cardiologist, AMNCH, Tallaght, the formation of the expert panel marks the launch of R3i in Ireland.

The global R3i foundation is a worldwide academic and multidisciplinary organisation, whose aim is to substantially extend and improve the lives of patients with heart disease or diabetes who have atherogenic dyslipidaemia (AD) and remain at significantly increased risk of vascular diseases including heart attacks, impaired kidney function, loss of sight and limb amputation despite receiving current standards of care.

The foundation is an independent, non-profit association funded by an educational grant from Solvay Pharmaceuticals. Further information for doctors is available at www.R3i.org.

The Irish group is joining similar specialist teams from 43 countries across North America, Europe, Asia and Japan to address this growing problem of residual vascular risk.

The Irish R3i committee met recently to discuss and evaluate this excessively high risk in Irish patients. Commenting after the meeting, Dr Durkan said that recent advances in CVD treatment and prevention were now seriously challenged by the impact of the global epidemics of obesity, metabolic syndrome, and type 2 diabetes.

“Meeting low-density lipoprotein (LDL) targets in clinical practice is admittedly a challenging objective. However, LDL cholesterol is not the only lipid that plays a role in residual vascular risk. Atherogenic dyslipidaemia, characterised by elevated triglycerides and a low plasma concentration of HDL cholesterol, often with elevated apolipoprotein B and non-HDL cholesterol, is prevalent in patients with type 2 diabetes, metabolic syndrome and established CVD. New thinking in CVD prevention is required to address the shortcomings in current treatment strategies,” she stated.
Phenotypically, individuals with AD tend to be obese, insulin resistant, and physically inactive.

“There is a range of research available which illustrates that greater reduction in low-density lipoprotein cholesterol, blood pressure and blood sugar alone is not sufficient impact on residual vascular risk,” added Dr Maher.

“Multifactorial intervention is required to combat CVD risk – aiming to achieve ‘all’ lipid targets, along with the early introduction of lifestyle modification. Inclusion of a fibrate, niacin or omega-3 fatty acids to statin therapy increases the likelihood of reaching lipid targets,” he said.

Posted in Health Management on 24 November 2009
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