Type 2 diabetes is a strong independent risk factor for cardiovascular events: the primary cause of death in patients with T2D. This module discusses how to manage CV risk in T2D.
Managing CV risk in type 2 diabetes
Approximately 50% of people with T2D still die from CV disease
Despite falling mortality rates, patients with T2D remain at increased risk of CV mortality
Life expectancy is reduced by ~12 years in patients with diabetes and CV disease
Reducing the risk of premature CV death is therefore a management priority for patients with T2D1,2
T2D is a CV risk factor that determines the need for cardioprotection
T2D is a CV risk factor that determines the need for cardioprotection
Multifactorial management is well established as standard of care for patients with T2D1,2
BP-lowering treatment reduces CV and mortality risk in patients with T2D
Statin therapy has a pivotal role in reducing CV risk
Antiplatelet therapy is recommended as a secondary prevention strategy in patients with T2D and CV disease1
ARRIVE: aspirin did not reduce the risk of major CV events in a primary prevention setting
Smoking cessation is associated with a significant reduction in acute myocardial infarction
Look AHEAD: randomised intensive lifestyle intervention, focused on weight loss, improved CV risk factors in T2D in the short term
Intensive lifestyle intervention, focused on weight loss, did not reduce CV outcomes in patients with T2D
ACC Expert Consensus Decision Pathway, 2018
Intensive versus standard glucose control has an effect on MI, but not mortality or heart failure
Glucose-lowering trials confirmed the benefit on microvascular complications but showed mixed results on macrovascular outcomes
Evidence from CVOTs has shown that some glucose-lowering agents have beneficial effects on CV outcomes
Global clinical recommendations have been updated as a result of this new evidence
Diabetes guidelines and societies now recommend a cardioprotective glucose-lowering agent for patients with T2D and CV disease
Cardiology guidelines now recommend a cardioprotective glucose-lowering agent for patients with T2D and CV disease
What does this mean for patient care?
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