Latin American Consensus on management of residual cardiometabolic risk. A consensus paper prepared by the Latin American Academy for the Study of Lipids and Cardiometabolic Risk (ALALIP) endorsed by the Inter-American Society of Cardiology (IASC), the International Atherosclerosis Society (IAS), and the Pan-American College of Endothelium (PACE)




Carlos I. Ponte-Negretti, Unit of Cardiometabolic Medicine, La Floresta Medical Institute, Caracas, Venezuela
Fernando Wyss, Technology and Cardiovascular Service of Guatemala - Cardiosolutions, Guatemala City, Guatemala
Daniel Piskorz, Institute of Cardiology Sanatorio Británico SRL Rosario, Argentina
Raul D. Santos, Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
Raul Villar, Integra Médica, La Serena, Chile
Alberto Lorenzatti, Department of Cardiology, Hospital Instituto Médico DAMIC/Rusculleda Foundation for Research in Medicine, Cordoba Argentina
Patricio López-Jaramillo, Integral Center for the Prevention of Cardiometabolic Diseases (CIPCA) and Instituto Masira, UDES, Bucaramanga, Colombia
Peter P. Toth, University of Illinois College of Medicine, Peoria, Illinois, Michigan State, USA
A. Juan J. Amaro, Clinica Santa Sofía, Caracas, Venezuela
Alfonso K. Rodrigo, Advanced Center for Metabolic Medicine and Nutrition, Santiago de Chile, Chile
Fernando Lanas, University of La Frontera, Temuco, Chile
Miguel Urina-Triana, Faculty of Health Sciences, Simón Bolívar University, Barranquilla Colombia
Jofre Lara, Department of Cardiology, Hospital Solca Guayaquil, Ecuador
T. Osiris Valdés, Central Medical Center La Romana, Dominican Republic
José R. Gomez-Mancebo, Department of Cardiology, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
Alfonso Bryce, CARDIOGOLF Research Unit, El Golf Clinic, Lima, Peru
Leonardo Cobos S., Cardiology Service, Hospital El Pino, Cardiocob Research Unit, Santiago de Chile, Chile
Adriana Puente-Barragán, Centro Médico Nacional 20 de Noviembre (ISSSTE), Mexico City, Mexico
Vladimir E. Ullauri-Solórzano, Hospital Metropolitano, Quito, Ecuador
Félix A. Medina-Palomino, Univeridad Peruana Cayetano, Hospital Nacional Cayetano Heredia, Peru
Alfredo F. Lozada, Austral University Hospital, Buenos Aires, Argentina
Maritza Duran, FISPEVEN (Foundation for Clinical Research in Public and Epidemiological Health in Venezuela), Clínica El Ávila, Caracas, Venezuela
Percy Berrospi, Cardiology Service, SANNA Clinica El Golf, Lima, Peru
David Miranda, Clínica San Felipe, Lima, Peru
Juan J. Badimon, Atherothrombosis Research Unit, Cardiovascular Institute, The Mount Sinai School of Medicine, New York, USA
J. José R. González, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
Peter Libby, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Womens’ Hospital, Harvard Medical School, Boston, MA, USA


Background: Hypertension, hyperglycemia, dyslipidemia, overweight, obesity, and tobacco (smoking, chewing, and vaping), together with a pro-inflammatory and procoagulant state, are the main risk factors related to atherosclerotic cardiovascular disease. Objective and methods: A group of experts from the Americas, based on their clinical expertise in cardiology, cardiovascular prevention, and cardiometabolic (CM) diseases, joined together to develop these practical recommendations for the optimal evaluation and treatment of residual CM risk factors in Latin America, using a modified Delphi methodology (details in electronic TSI) to generate a comprehensive CM risk reduction guideline, and through personalized medicine and patient-centered decision, considering the cost-benefit ratio The process was well defined to avoid conflicts of interest that could bias the discussion and recommendations. Results: Residual risk reduction should consider therapeutic options adapted to specific patient needs, based on five treatment objectives: triglyceride-rich lipoproteins, inflammation, impaired glucose metabolism, high blood pressure, and prothrombotic status. Comprehensive control of all CM risk factors should be a priority to deal with this important public health problem and prevent premature deaths. The recommendations in this paper address the evidence-based treatment of CM risk and are intended for clinical application in Latin American countries.



Keywords: Residual risk. Cardiovascular risk. Cardiometabolic risk factors. Atherosclerotic cardiovascular disease. Inflammation. Thrombosis.