Initiative by world-recognized specialists in heart disease and diabetes to reduce residual vascular risk

Nov 10 2008

Residual Risk Reduction Initiative (R3i) Calls for Action to Reduce the Lipid-Related Residual Vascular Risk Unaddressed by Current Standards of Care in Millions of Patients With Heart Disease and Diabetes.

Internationally recognized specialists from North America, Europe, Asia and Japan have come together today to launch the Residual Risk Reduction initiative (R3i) - a unique global program to evaluate and reduce the excess risk of myocardial infarction, stroke, kidney disease, loss of vision and non-traumatic limb amputation which exists in many patients with heart disease and diabetes despite optimal, currently available care.

The R3i, a worldwide, academic, multidisciplinary non-profit organization, aims to successfully address the excessively high risk of macro- and microvascular complications in patients with atherogenic dyslipidemia, characterized by elevated triglycerides and low levels of high-density lipoprotein (HDL) cholesterol and unaddressed by current standards of care. This lipid abnormality is typical in patients with type 2 diabetes or metabolic syndrome and common in patients with established cardiovascular disease.

The President of the R3i, Professor Jean-Charles Fruchart of the University of Lille, France said: "We now have unequivocal evidence from numerous studies showing that greater reductions in low-density lipoprotein cholesterol, blood pressure and blood sugar alone will have little, if any, additional impact on residual vascular risk. Therefore, we urgently need new strategies to address other modifiable risk factors such as atherogenic dyslipidemia, a strong contributor to residual vascular risk in millions of patients with diabetes and cardiovascular disease."

The R3i will address this major public health problem. In its manifesto published today in Diabetes & Vascular Disease Research (Diabetes Vasc Dis Res 2008;5:319-35) and in a supplement to the American Journal of Cardiology (Am J Cardiol 2008:102:Supplement 10A ), the R3i calls for:

• Original research to quantify the full extent of residual vascular risk in patients with atherogenic dyslipidemia and to identify new targets for interventions.
• Educational programs to create awareness of residual vascular risk and to encourage healthcare professionals, particularly Primary Care Physicians (PCPs), to translate available research findings into improved treatment strategies.
• Advocacy to ensure that the issue of residual vascular risk associated with atherogenic dyslipidemia is given appropriate priority in national and international guidelines.  

"Our overall goal must be to provide knowledge and understanding to allow physicians to get closer to normalizing residual vascular risk in patients with heart disease and/or diabetes," Frank Sacks, Professor of Cardiovascular Disease Prevention, Harvard School of Public Health, Professor of Medicine, Harvard Medical School, Boston, USA and Vice-president of R3i, said. "We hope that the original research conducted under the auspices of R3i and the widespread communication of current knowledge and new data will lead to significant improvements in the reduction of risk beyond the levels we achieve now. Despite significant advances in reducing vascular risk in the last 20 years, we have only just begun to address this issue. We invite our colleagues to join us in addressing this important challenge."

The R3i is led by a Board of Trustees and an International Steering Committee (ISC) of 21 officers and members from the disciplines of cardiology, diabetology, lipidology, endocrinology, epidemiology, nutrition, ophthalmology, nephrology and basic science. The legal body of the R3i will be a Foundation established in Switzerland. National organizations have been or are in the process of being established in more than 40 countries worldwide. These beneficiaries of the R3i Foundation will implement research and educational programs in their respective countries and will also initiate their own national initiatives, according to the mission of the R3i.

The R3i Foundation will seek funding from multiple sources. Initial seed funding was provided by Solvay Pharmaceuticals.

Initial research and education programs focus on extent of residual vascular risk

The initial R3i research program involves two worldwide epidemiological surveys which aim to quantify the full extent of residual macro- and microvascular risk associated with atherogenic dyslipidemia in patients with heart disease and/or type 2 diabetes receiving current standards of care.

Additionally, this research will generate hypotheses about the role of lipid abnormalities such as atherogenicity of serum triglycerides and atheroprotection of high density lipoprotein cholesterol (HDL-C) in the future management of residual vascular risk.

The R3i in its commitment to education has already begun to develop educational tool kits including a resource slide kit and a dedicated website including a CME-accredited program. This will facilitate live web seminars (webinars) allowing physicians to interact and communicate with each other across the globe.

For Notes to Editors, details of the Board of Trustees and the International Steering Committee, countries where R3i national organizations have been or are in the process of being established and references please go to the R3i website: http://www.r3i.org/

The website contains information on the members, the mission, the research and the education programs. It also features links to various resources discussing residual vascular risk.