The Present and Future
State-of-the-Art Review
Primary Prevention of Cardiovascular Disease in Diabetes Mellitus

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Abstract

Type 2 diabetes mellitus (T2D) is a major risk factor for cardiovascular disease (CVD), the most common cause of death in T2D. Yet, <50% of U.S. adults with T2D meet recommended guidelines for CVD prevention. The burden of T2D is increasing: by 2050, approximately 1 in 3 U.S. individuals may have T2D, and patients with T2D will comprise an increasingly large proportion of the CVD population. The authors believe it is imperative that we expand the use of therapies proven to reduce CVD risk in patients with T2D. The authors summarize evidence and guidelines for lifestyle (exercise, nutrition, and weight management) and CVD risk factor (blood pressure, cholesterol and blood lipids, glycemic control, and the use of aspirin) management for the prevention of CVD among patients with T2D. The authors believe appropriate lifestyle and CVD risk factor management has the potential to significantly reduce the burden of CVD among patients with T2D.

Key Words

cardiovascular disease
primary prevention
type 2 diabetes

Abbreviations and Acronyms

ACC
American College of Cardiology
ACE
angiotensin-converting enzyme
ADA
American Diabetes Association
AHA
American Heart Association
ARB
angiotensin II receptor blocker
BMI
body mass index
BP
blood pressure
CI
confidence interval
CV
cardiovascular
CVD
cardiovascular disease
DBP
diastolic blood pressure
DPP
Diabetes Prevention Project
GI
gastrointestinal
HbA1c
glycosylated hemoglobin
HDL-C
high-density lipoprotein cholesterol
HR
hazard ratio
LDL-C
low-density lipoprotein cholesterol
MI
myocardial infarction
RCT
randomized clinical trial
SBP
systolic blood pressure
T1D
type 1 diabetes
T2D
type 2 diabetes

Cited by (0)

Dr. Newman was partially funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) (K23HL125991) and the American Heart Association Mentored Clinical and Population Research Award (15MCPRP24480132). Dr. Berger was partially funded by the NHLBI of the NIH (HL114978). Funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the article. Dr. Weintraub has received honoraria from Amgen, Sanofi, and Gilead for consulting; has served on the speakers bureau for Amgen; and has received research funding from Amarin and Sanofi. Dr. Berger has received research funding from AstraZeneca and Janssen. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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© 2017 by the American College of Cardiology Foundation. Published by Elsevier.