title: Statin-centric versus low-density lipoprotein-centric approach for atherosclerotic cardiovascular disease prevention: a Singapore perspective.
abstract: 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.
authors.affiliation: Peter Yan Cardiology Clinic, Gleneagles Hospital, Singapore.
authors.forename: Peter
authors.initials: P
authors.lastname: Yan
authors.affiliation: Kevin Tan Clinic for Diabetes, Thyroid and Hormones Pte Ltd, Mount Elizabeth Medical Centre, Singapore.
authors.forename: Eng Kiat Kevin
authors.initials: EK
authors.lastname: Tan
authors.affiliation: Department of Renal Medicine, Singapore General Hospital, Singapore.
authors.forename: Jason Chon Jun
authors.initials: JC
authors.lastname: Choo
authors.affiliation: Raffles Diabetes and Endocrine Centre, Raffles Hospital, Singapore.
authors.forename: Choon Fong Stanley
authors.initials: CF
authors.lastname: Liew
authors.affiliation: Division of Nephrology, National University Health System, National University Hospital, Singapore.
authors.forename: Titus
authors.initials: T
authors.lastname: Lau
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: Waters
mesh_terms: D000375:Aging; D050197:Atherosclerosis / Q000188:drug therapy*; D002309:Cardiology / Q000592:standards; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008019:Life Style; D008077:Lipoproteins, LDL / Q000097:blood*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D012846:Singapore
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL
keywords: Singapore; atherosclerosis; cardiovascular disease; lipids