Key result
Optimizing statin therapy for high-risk Asians requires locally validated ASCVD risk tools in Singapore.
This review provides expert consensus and principles for managing cardiovascular risk with statin therapy tailored to the Singaporean population.
Local validation of ASCVD risk tools needed in Singapore; leaves open optimal statin use for high-risk Asian patients under current guidelines.
The link between cholesterol levels and atherosclerotic cardiovascular disease (ASCVD) is well-established. In Singapore, there is an increasing prevalence of risk factors for ASCVD. Like many Asian countries, Singapore's population is rapidly ageing and increasingly sedentary, which predisposes individuals to chronic health problems. Current international and local guidelines recommend statin therapy for the primary and secondary prevention of ASCVD. However, despite the effectiveness of statin therapy, some studies have highlighted that Asian patients with cardiovascular disease are not achieving target lipid goals. Furthermore, it is widely believed that the responses of Asians (both patients and physicians) to statin therapy are different from those of their Western counterparts. Experts convened in 2014 to determine the impact of current guidelines on clinical practice in Singapore. This review summarises the key findings and recommendations of these guidelines, and presents key principles to aid clinicians to manage the cardiovascular risk of their patients more effectively.
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Yan et al. (2016) conducted a review in Atherosclerotic cardiovascular disease. Statin therapy was evaluated. Current guidelines recommend statin therapy for ASCVD prevention, but a locally validated risk assessment tool is needed in Singapore to address the underdosing of high-risk Asian patients.
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