TY - JOUR
T1 - Primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk
T2 - An endocrine society clinical practice guideline
AU - Rosenzweig, James L.
AU - Ferrannini, Ele
AU - Grundy, Scott M
AU - Haffner, Steven M.
AU - Heine, Robert J.
AU - Horton, Edward S.
AU - Kawamori, Ryuzo
AU - Edwards, Heather
N1 - Funding Information:
James L. Rosenzweig, M.D. (chair) – Significant Financial Interests: none declared; Governance: National Diabetes Quality Improvement Alliance; Consultation or Advisement: AMA Physician Consortium for Performance Improvement Advisory Committee, Alere Medical Scientific Advisory Board, Blue Cross-Blue Shield of Massachusetts Advisory Board, National Quality Forum Technical Advisory Panel, Disease Management Association of America Advisory Board; Grant or Other Research Support: Ruby Linn Foundation; Honoraria: Alere Medical, Merck, Healthways; Philips Medical, Sanofi-Aventis; Speakers Bureau: Bristol-Myers Squibb; Merck, Sanofi-Aventis; Ele Ferrannini, M.D. – Significant Financial Interests: none declared; Governance: none declared; Consultation or Advisement: none declared; Grant or Other Research Support: none declared; Honoraria: none declared; Speakers Bureau: none declared; Scott Grundy, M.D. – Significant Financial Interests: none declared; Governance: none declared; Consultation or Advisement: Pfizer, Abbott, Astra Zeneca, Sanofi Aventis, Merck, Grant or Other Research Support: Merck, Abbott, Kos, GlaxoSmith Kline, Donald W. Reynolds Fund, Veterans Affairs, National Institutes of Health; Honoraria: Merck, Pfizer, Sankyo, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, AstraZeneca; Speakers Bureau: none declared; Steven M. Haffner, M.D. – Significant Financial Interests: none declared; Governance: none declared; Consultation or Advisement: Pfizer, Merck & Company, Inc.; Grant or Other Research Support: National Institutes of Health, GlaxoSmithKline, Novartis, Pfizer, AstraZeneca; Honoraria: none declared; Speakers Bureau: Sanofi-Aventis, Novartis, GlaxoSmithKline, Merck & Company, Inc., Pfizer, Eli Lilly, AstraZeneca; Robert J. Heine, M.D., Ph.D. – Significant Financial Interests: Eli-Lilly*; Governance: none declared; Consultation or Advisement: Novartis, Merck, Sanofi-Aventis, Bristol-Myers Squibb, Novo Nordisk, Amylin; Grant or Other Research Support: Novartis, Sanofi-Aventis, Merck, Novo Nordisk, Eli Lilly; Honoraria: none declared; Edward S. Horton, M.D. – Significant Financial Interests: none declared; Governance: none declared; Consultation or Advisement: Novartis, Merck, Takeda, Novo Nordisk, Sankyo, Pfizer; Grant or Other Research Support: none declared; Honoraria: Advisory Boards, Data Safety Monitoring Boards, Novartis, Merck, Takeda, Novo Nordisk, Sankyo, Pfizer; Ryuzo Kawamori, M.D. – Significant Financial Interests: none declared; Governance: none declared; Consultation or Advisement: Takeda, Astra Zeneca; Grant or Other Research Support: none declared; Honoraria: none declared. Speakers Bureau: Takeda, Novo Nordisk.
PY - 2008/10
Y1 - 2008/10
N2 - Objective: The objective was to develop clinical practice guidelines for the primary prevention of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) in patients at metabolic risk. Conclusions: Healthcare providers should incorporate into their practice concrete measures to reduce the risk of developing CVD and T2DM. These include the regular screening and identification of patients at metabolic risk (at higher risk for both CVD and T2DM) with measurement of blood pressure, waist circumference, fasting lipid profile, and fasting glucose. All patients identified as having metabolic risk should undergo 10-yr global risk assessment for either CVD or coronary heart disease. This scoring will determine the targets of therapy for reduction of apolipoprotein B-containing lipoproteins. Careful attention should be given to the treatment of elevated blood pressure to the targets outlined in this guideline. The prothrombotic state associated with metabolic risk should be treated with lifestyle modification measures and in appropriate individuals with low-dose aspirin prophylaxis. Patients with prediabetes (impaired glucose tolerance or impaired fasting glucose) should be screened at 1- to 2-yr intervals for the development of diabetes with either measurement of fasting plasma glucose or a 2-h oral glucose tolerance test. For the prevention of CVD and T2DM, we recommend that priority be given to lifestyle management. This includes antiatherogenic dietary modification, a program of increased physical activity, and weight reduction. Efforts to promote lifestyle modification should be considered an important component of the medical management of patients to reduce the risk of both CVD and T2DM.
AB - Objective: The objective was to develop clinical practice guidelines for the primary prevention of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) in patients at metabolic risk. Conclusions: Healthcare providers should incorporate into their practice concrete measures to reduce the risk of developing CVD and T2DM. These include the regular screening and identification of patients at metabolic risk (at higher risk for both CVD and T2DM) with measurement of blood pressure, waist circumference, fasting lipid profile, and fasting glucose. All patients identified as having metabolic risk should undergo 10-yr global risk assessment for either CVD or coronary heart disease. This scoring will determine the targets of therapy for reduction of apolipoprotein B-containing lipoproteins. Careful attention should be given to the treatment of elevated blood pressure to the targets outlined in this guideline. The prothrombotic state associated with metabolic risk should be treated with lifestyle modification measures and in appropriate individuals with low-dose aspirin prophylaxis. Patients with prediabetes (impaired glucose tolerance or impaired fasting glucose) should be screened at 1- to 2-yr intervals for the development of diabetes with either measurement of fasting plasma glucose or a 2-h oral glucose tolerance test. For the prevention of CVD and T2DM, we recommend that priority be given to lifestyle management. This includes antiatherogenic dietary modification, a program of increased physical activity, and weight reduction. Efforts to promote lifestyle modification should be considered an important component of the medical management of patients to reduce the risk of both CVD and T2DM.
UR - http://www.scopus.com/inward/record.url?scp=53749091518&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=53749091518&partnerID=8YFLogxK
U2 - 10.1210/jc.2008-0222
DO - 10.1210/jc.2008-0222
M3 - Article
C2 - 18664543
AN - SCOPUS:53749091518
SN - 0021-972X
VL - 93
SP - 3671
EP - 3689
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 10
ER -