[Cardiovascular prevention in diabetic patients: an evidenced-based review].
Diabetes mellitus is a condition associated with cardiac complications, especially artherothrombotic disease. Several studies have demonstrated the importance of reducing cardiovascular burden on this population by adopting prevention strategies. This article revised clinical evidences on cardiovascular risk assessment and prevention actions, taking into consideration major recommendations in the field. Life-style changes with low-carbohydrate diet, weight control, and regular physical activity must be implemented. High-risk patients or with established cardiovascular disease ought to have glycemic levels<100 mg/dL and A1c<7%. It is recommended low dose of aspirin and statin for lipid management, targeting LDL<100 mg/dL, HDL>50 mg/dL and tryglycerides<150 mg/dL. Blood pressure control with non-pharmacological and antihypertensive drugs must be instituted, favoring ACE inhibitors as first option, mainly in patients with renal disease, and combined with tiazydes for the majority to achieve target blood pressure of <130/80 mmHg.
Furtado
Mariana Vargas
MV
Serviço de Cardiologia, Hospital de Clínicas de Porto Alegre, Departamento de Medicina Interna da Universidade Federal do Rio Grande do Sul, RS, Brazil.
Polanczyk
Carisi Anne
CA
D001794:Blood Pressure; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000150:complications / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D009203:Myocardial Infarction / Q000517:prevention & control; D012307:Risk Factors