About The Initiative

The Residual Risk Reduction Initiative (R3i) is a multidisciplinary, non-profit foundation established under Swiss law. Founded by international researchers and clinicians, at the initiative of Professor Jean-Charles Fruchart. R3i was created in response to the significant risk of both fatal and non-fatal macro- and micro-vascular complications in patients who are unaddressed by current standards of care.

The R3i is led by a Board of Trustees and an International Steering Committee (ISC) of officers and members from the disciplines of cardiology, diabetology, lipidology, endocrinology, epidemiology, nutrition, ophthalmology, nephrology and basic science. The R3i Foundation was launched in November 2008, with Professor Jean-Charles Fruchart serving as its first President.

The objectives and programs of the R3i are defined in a manifesto published as a position paper in Diabetes and Vascular Disease Research (executive statement) and a supplement to The American Journal of Cardiology (full statement).1,2

The R3i is accredited by American Accreditation Commission International (AACI), one of the most experienced organizations in the provision of healthcare organization accreditation and clinical excellence certification services. AACI has awarded full medical content certification to the R3i from 2020 through to 2027

 It is my honor to have been selected as the President of the Residual Risk Reduction Initiative (R3i.) This foundation is dedicated to combatting cardiovascular disease, the number one killer and contributor to loss of productive life years globally. We are fortunate to possess an extensive toolkit of interventions to attack the traditional risk factors for atherosclerotic cardiovascular disease, a major manifestation of this constellation of conditions. Yet, with the spreading epidemic of obesity and diabetes and the epidemiologic transition in low- and middle-income countries leading to replacement of chronic cardiovascular disease versus communicable diseases, we face a growing challenge of cardiometabolic risk. Further progress in reducing morbidity and mortality due to cardiovascular disease globally will require not only research to identify new targets and develop new therapies but also implementation and efforts to control emerging threats to cardiovascular and other aspects of health. These challenges include air, noise, and light pollution, the ubiquity of nanoplastics, and healthcare disparities based on geographical and socio-economic status. I am passionate about the R3i initiative to attack residual risk that persists despite current therapies and the Foundation’s multi-pronged approach to this mission that unites academia, practitioners, the pharmaceutical industry, and biotechnology enterprises in a united effort towards these ends. We will strive to include patient voices as we face the future and continue our core commitment to diversity and a global reach.

R3i was founded by the visionary Jean-Charles Fruchart who presided this organization until his untimely death. I assume the mantle of leadership of this important initiative, with great humility and devotion, to better human knowledge and promote public health and the conquest of cardiovascular disease.

Sincerely yours,

Peter Libby, MD

The mission of the Residual Risk Reduction Initiative (R3i) is to actively engage healthcare professionals in a global effort to combat the high incidence of macro-and micro-vascular complications in patients with residual vascular risk and unaddressed by current standards of care. By providing comprehensive education, and advocating for policy changes, we aim to significantly enhance the quality of life and longevity for millions affected by cardiovascular disease and diabetes.

The vision of the Residual Risk Reduction Initiative (R3i) is to substantially extend and improve the lives of patients with heart disease and/or diabetes who remain at significantly increased risk of vascular diseases including heart attacks, impaired kidney function, loss of sight and limb amputation despite receiving current standards of care.

What does the R3i achieve?

The initiative has three major areas of activity:

To create awareness of Residual Vascular Risk and encourage healthcare professionals, particularly Primary Care Physicians (PCPs), to translate the results of research into improved treatment strategies by providing global education programs:

– R3i website

– publications

– educational booklets editing

– access to slides kit library

– Webinars (live web conferences)

To prioritize the importance of addressing the issue of Residual Vascular Risk within international and national guidelines. This involves producing publications such as position papers and literature reviews, organizing scientific sessions at major international congresses, and hosting press events at these congresses. Additionally, we collaborate with healthcare professionals and policymakers to further promote this critical issue.

To evaluate the full extent of Residual Vascular Risk in patients with atherogenic dyslipidemia and to identify new targets for interventions.

– REALIST (REsiduAl risk, Lipids and Standard Therapies): 1st worldwide epidemiological survey to establish the link between TG/HDL-C and risk of CVD events (MACROvascular epidemiological survey) and microvascular complications of type 2 diabetes (MICROvascular epidemiological survey)

– Independent research grants related to Residual Vascular Risk

• 1. Fruchart JC, Sacks FM, Hermans MP, et al. The Residual Risk Reduction initiative: A call to action to reduce Residual vascular Risk in dyslipidemic patients. A condensed position paper by the Residual Risk Reduction Initiative (R3i). Diabetes Vasc Dis Res 2008;5:319-35.
• 2. Fruchart JC, Sacks FM, Hermans MP, et al. The Residual Risk Reduction initiative: A call to action to reduce Residual vascular Risk in dyslipidemic patients. A full position paper by the Residual Risk Reduction Initiative (R3i). Am J Cardiol 2008:102:Supplement 10A.