Comprehensive risk reduction of cardiovascular risk factors in the diabetic patient: an integrated approach.
Diabetic patients are at increased risk of CV disease morbidity and mortality. In the past,treatment of diabetic patients largely focused on tight glycemic control. A number of studies,however, have shown that aggressive control of blood pressure and hyperlipidemia and the institution of antithrombotic therapy are beneficial in reducing the risk of CV events in the diabetic patient. Although in general these studies have shown a 15% to 30% reduction in the RR of CV events, the absolute risk of CV events remains high in the intervention group, probably because most of these trials have not incorporated a comprehensive risk-reduction strategy. Emerging data suggest that a therapeutic strategy using appropriate therapy to address multiple components of CV risks in diabetic patients is indeed beneficial in reducing the absolute risk of CV events. Although more data are needed to substantiate the benefits, feasibility, and cost effectiveness of such therapy, there is sufficient evidence for the clinician to provide an individualized approach and to consider aggressive intervention to minimize the predictable risk of CV events in the high-risk diabetic patient.
Srikanth
Sundararajan
S
Department of Medicine, VA Central California Health Care System/University Medical Center, University of California, San Francisco Program at Fresno, 2615 East Clinton Avenue, Fresno, CA 93703, USA.
Deedwania
Prakash
P
D000959:Antihypertensive Agents / Q000627:therapeutic use; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003925:Diabetic Angiopathies / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D012307:Risk Factors
D000959:Antihypertensive Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007004:Hypoglycemic Agents