Prevalence, awareness and treatment of cardiovascular risk factors in patients at high risk of atherothrombosis in Japan.

BACKGROUND: The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international observational study of patients with, or at risk of, atherothrombotic disease. Japanese patients were analyzed to clarify national prevalence and treatment. METHODS AND RESULTS: Almost 68,000 outpatients were recruited worldwide with 5,193 in Japan. Among the Japanese patients, 83.7% had established vascular disease (symptomatic) and 16.3% had risk factors only (asymptomatic). Of the symptomatic patients, 14.0% had atherothrombotic lesions in more than 1 vascular bed, with 0.8% having lesions in 3 areas: brain, heart, and peripheral arteries. The prevalence of additional atherothrombotic risk factors among symptomatic patients was independent of the vascular lesion. Obesity was recorded in 10.6% and 42.1% of patients according to the National Cholesterol Education Program and Japanese guidelines, respectively. Pharmacologic intervention for risk factors was inadequate: only 37.7% of diabetic patients received antidiabetic medication, 79.6% of hypertensive patients used antihypertensives, and 74.0% received antiplatelet agents. The use of statins (44.1%) and aspirin (54.7%) was less common than seen in REACH globally. CONCLUSIONS: Japanese patients enrolled in REACH share many similarities with the global population, but with some important differences. Long-term follow-up will determine the impact of these factors on the development of atherothrombotic events.