Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention
Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). Secular changes in CVD outcomes have occurred over the past few decades, mainly due to a decline in the incidence of ischaemic heart disease. The onset of T2DM at a y...
Gespeichert in:
| Veröffentlicht in: | Nature reviews cardiology 2023-10, Vol.20 (10), p.685-695 |
|---|---|
| Hauptverfasser: | , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 695 |
|---|---|
| container_issue | 10 |
| container_start_page | 685 |
| container_title | Nature reviews cardiology |
| container_volume | 20 |
| creator | Wong, Nathan D. Sattar, Naveed |
| description | Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). Secular changes in CVD outcomes have occurred over the past few decades, mainly due to a decline in the incidence of ischaemic heart disease. The onset of T2DM at a young age ( |
| doi_str_mv | 10.1038/s41569-023-00877-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2814816796</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2864401217</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-ba1b0c2b0cf81e48693241c77ff7e9df6ab823feaaca90e02d38771ecb04b2703</originalsourceid><addsrcrecordid>eNp9kE1LxDAQhoMorl9_wIMUvHiwOknapvUmi18giKDnkLZTibbNmmkF99cbra7gwUPIQJ55Z_Iwts_hhIPMTynhaVbEIGQMkCsVL9fYFldpEafAYX1Vg5ixbaJngCxRqdxkM6l4IfM022L3c-Nr694MVWNrfOQtvUS2j2prShyQog7b1g4jnUW4sDV21rXu6f04MkRI1GE_RKavo4XHt1Bb1--yjca0hHvf9w57vLx4mF_Ht3dXN_Pz27iSKh3i0vASKhFOk3NM8qyQIuGVUk2jsKibzJS5kA0aU5kCEEQtwxc5ViUkpVAgd9jRlLvw7nVEGnRnqQrbmh7dSFrkPMl5poosoId_0Gc3-j5sF6gsSYALrgIlJqryjshjoxfedsa_aw76U7iehOsgXH8J18vQdPAdPZYd1quWH8MBkBNA4al_Qv87-5_YD0GYjRY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2864401217</pqid></control><display><type>article</type><title>Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention</title><source>Alma/SFX Local Collection</source><creator>Wong, Nathan D. ; Sattar, Naveed</creator><creatorcontrib>Wong, Nathan D. ; Sattar, Naveed</creatorcontrib><description>Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). Secular changes in CVD outcomes have occurred over the past few decades, mainly due to a decline in the incidence of ischaemic heart disease. The onset of T2DM at a young age (<40 years), leading to a greater number of life-years lost, has also become increasingly common. Researchers are now looking beyond established risk factors in patients with T2DM towards the role of ectopic fat and, potentially, haemodynamic abnormalities in mediating important outcomes (such as heart failure). T2DM confers a wide spectrum of risk and is not necessarily a CVD risk equivalent, indicating the importance of risk assessment strategies (such as global risk scoring, consideration of risk-enhancing factors and assessment of subclinical atherosclerosis) to inform treatment. Data from epidemiological studies and clinical trials demonstrate that successful control of multiple risk factors can reduce the risk of CVD events by ≥50%; however, only ≤20% of patients achieve targets for risk factor reduction (plasma lipid levels, blood pressure, glycaemic control, body weight and non-smoking status). Improvements in composite risk factor control with lifestyle management (including a greater emphasis on weight loss interventions) and evidence-based generic and novel pharmacological therapies are therefore needed when the risk of CVD is high.
Individuals with type 2 diabetes mellitus are at high risk of developing cardiovascular disease (CVD). In the context of type 2 diabetes mellitus, Wong and Sattar discuss established and novel mechanisms of CVD, risk assessment and patient stratification, and strategies to reduce multiple risk factors to prevent CVD.
Key points
Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM).
Beyond glycaemia, evidence exists for the ‘upstream’ role of excess ectopic fat in mediating important CVD outcomes in individuals with T2DM.
Individuals with T2DM have a wide spectrum of risks that warrant assessment, including global risk scoring, consideration of risk-enhancing factors and, in subgroups, assessment of subclinical atherosclerosis to inform treatment.
Strategies to reduce the risk of CVD in individuals with T2DM include lifestyle management as the foundation, followed by pharmacological management to optimize plasma lipid levels, blood pressure and glycaemic control.
Epidemiological and clinical trial data show that the control of multiple risk factors is associated with ≥50% reductions in CVD events, but only ≤20% of individuals with T2DM achieve risk factor targets.
Improvements are needed to achieve composite risk factor control by comprehensive lifestyle and pharmacological approaches, including new evidence-based therapies for T2DM that reduce CVD outcomes by mechanisms not yet fully understood.</description><identifier>ISSN: 1759-5002</identifier><identifier>ISSN: 1759-5010</identifier><identifier>EISSN: 1759-5010</identifier><identifier>DOI: 10.1038/s41569-023-00877-z</identifier><identifier>PMID: 37193856</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/163 ; 692/4019 ; Cardiac Imaging ; Cardiac Surgery ; Cardiology ; Diabetes ; Epidemiology ; Medicine ; Medicine & Public Health ; Review Article ; Risk assessment ; Risk factors</subject><ispartof>Nature reviews cardiology, 2023-10, Vol.20 (10), p.685-695</ispartof><rights>Springer Nature Limited 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Springer Nature Limited.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ba1b0c2b0cf81e48693241c77ff7e9df6ab823feaaca90e02d38771ecb04b2703</citedby><cites>FETCH-LOGICAL-c375t-ba1b0c2b0cf81e48693241c77ff7e9df6ab823feaaca90e02d38771ecb04b2703</cites><orcidid>0000-0003-1102-7324 ; 0000-0002-1604-2593</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37193856$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wong, Nathan D.</creatorcontrib><creatorcontrib>Sattar, Naveed</creatorcontrib><title>Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention</title><title>Nature reviews cardiology</title><addtitle>Nat Rev Cardiol</addtitle><addtitle>Nat Rev Cardiol</addtitle><description>Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). Secular changes in CVD outcomes have occurred over the past few decades, mainly due to a decline in the incidence of ischaemic heart disease. The onset of T2DM at a young age (<40 years), leading to a greater number of life-years lost, has also become increasingly common. Researchers are now looking beyond established risk factors in patients with T2DM towards the role of ectopic fat and, potentially, haemodynamic abnormalities in mediating important outcomes (such as heart failure). T2DM confers a wide spectrum of risk and is not necessarily a CVD risk equivalent, indicating the importance of risk assessment strategies (such as global risk scoring, consideration of risk-enhancing factors and assessment of subclinical atherosclerosis) to inform treatment. Data from epidemiological studies and clinical trials demonstrate that successful control of multiple risk factors can reduce the risk of CVD events by ≥50%; however, only ≤20% of patients achieve targets for risk factor reduction (plasma lipid levels, blood pressure, glycaemic control, body weight and non-smoking status). Improvements in composite risk factor control with lifestyle management (including a greater emphasis on weight loss interventions) and evidence-based generic and novel pharmacological therapies are therefore needed when the risk of CVD is high.
Individuals with type 2 diabetes mellitus are at high risk of developing cardiovascular disease (CVD). In the context of type 2 diabetes mellitus, Wong and Sattar discuss established and novel mechanisms of CVD, risk assessment and patient stratification, and strategies to reduce multiple risk factors to prevent CVD.
Key points
Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM).
Beyond glycaemia, evidence exists for the ‘upstream’ role of excess ectopic fat in mediating important CVD outcomes in individuals with T2DM.
Individuals with T2DM have a wide spectrum of risks that warrant assessment, including global risk scoring, consideration of risk-enhancing factors and, in subgroups, assessment of subclinical atherosclerosis to inform treatment.
Strategies to reduce the risk of CVD in individuals with T2DM include lifestyle management as the foundation, followed by pharmacological management to optimize plasma lipid levels, blood pressure and glycaemic control.
Epidemiological and clinical trial data show that the control of multiple risk factors is associated with ≥50% reductions in CVD events, but only ≤20% of individuals with T2DM achieve risk factor targets.
Improvements are needed to achieve composite risk factor control by comprehensive lifestyle and pharmacological approaches, including new evidence-based therapies for T2DM that reduce CVD outcomes by mechanisms not yet fully understood.</description><subject>692/163</subject><subject>692/4019</subject><subject>Cardiac Imaging</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Diabetes</subject><subject>Epidemiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Review Article</subject><subject>Risk assessment</subject><subject>Risk factors</subject><issn>1759-5002</issn><issn>1759-5010</issn><issn>1759-5010</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1LxDAQhoMorl9_wIMUvHiwOknapvUmi18giKDnkLZTibbNmmkF99cbra7gwUPIQJ55Z_Iwts_hhIPMTynhaVbEIGQMkCsVL9fYFldpEafAYX1Vg5ixbaJngCxRqdxkM6l4IfM022L3c-Nr694MVWNrfOQtvUS2j2prShyQog7b1g4jnUW4sDV21rXu6f04MkRI1GE_RKavo4XHt1Bb1--yjca0hHvf9w57vLx4mF_Ht3dXN_Pz27iSKh3i0vASKhFOk3NM8qyQIuGVUk2jsKibzJS5kA0aU5kCEEQtwxc5ViUkpVAgd9jRlLvw7nVEGnRnqQrbmh7dSFrkPMl5poosoId_0Gc3-j5sF6gsSYALrgIlJqryjshjoxfedsa_aw76U7iehOsgXH8J18vQdPAdPZYd1quWH8MBkBNA4al_Qv87-5_YD0GYjRY</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Wong, Nathan D.</creator><creator>Sattar, Naveed</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1102-7324</orcidid><orcidid>https://orcid.org/0000-0002-1604-2593</orcidid></search><sort><creationdate>20231001</creationdate><title>Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention</title><author>Wong, Nathan D. ; Sattar, Naveed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-ba1b0c2b0cf81e48693241c77ff7e9df6ab823feaaca90e02d38771ecb04b2703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>692/163</topic><topic>692/4019</topic><topic>Cardiac Imaging</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Diabetes</topic><topic>Epidemiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Review Article</topic><topic>Risk assessment</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wong, Nathan D.</creatorcontrib><creatorcontrib>Sattar, Naveed</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Nature reviews cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wong, Nathan D.</au><au>Sattar, Naveed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention</atitle><jtitle>Nature reviews cardiology</jtitle><stitle>Nat Rev Cardiol</stitle><addtitle>Nat Rev Cardiol</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>20</volume><issue>10</issue><spage>685</spage><epage>695</epage><pages>685-695</pages><issn>1759-5002</issn><issn>1759-5010</issn><eissn>1759-5010</eissn><abstract>Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). Secular changes in CVD outcomes have occurred over the past few decades, mainly due to a decline in the incidence of ischaemic heart disease. The onset of T2DM at a young age (<40 years), leading to a greater number of life-years lost, has also become increasingly common. Researchers are now looking beyond established risk factors in patients with T2DM towards the role of ectopic fat and, potentially, haemodynamic abnormalities in mediating important outcomes (such as heart failure). T2DM confers a wide spectrum of risk and is not necessarily a CVD risk equivalent, indicating the importance of risk assessment strategies (such as global risk scoring, consideration of risk-enhancing factors and assessment of subclinical atherosclerosis) to inform treatment. Data from epidemiological studies and clinical trials demonstrate that successful control of multiple risk factors can reduce the risk of CVD events by ≥50%; however, only ≤20% of patients achieve targets for risk factor reduction (plasma lipid levels, blood pressure, glycaemic control, body weight and non-smoking status). Improvements in composite risk factor control with lifestyle management (including a greater emphasis on weight loss interventions) and evidence-based generic and novel pharmacological therapies are therefore needed when the risk of CVD is high.
Individuals with type 2 diabetes mellitus are at high risk of developing cardiovascular disease (CVD). In the context of type 2 diabetes mellitus, Wong and Sattar discuss established and novel mechanisms of CVD, risk assessment and patient stratification, and strategies to reduce multiple risk factors to prevent CVD.
Key points
Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM).
Beyond glycaemia, evidence exists for the ‘upstream’ role of excess ectopic fat in mediating important CVD outcomes in individuals with T2DM.
Individuals with T2DM have a wide spectrum of risks that warrant assessment, including global risk scoring, consideration of risk-enhancing factors and, in subgroups, assessment of subclinical atherosclerosis to inform treatment.
Strategies to reduce the risk of CVD in individuals with T2DM include lifestyle management as the foundation, followed by pharmacological management to optimize plasma lipid levels, blood pressure and glycaemic control.
Epidemiological and clinical trial data show that the control of multiple risk factors is associated with ≥50% reductions in CVD events, but only ≤20% of individuals with T2DM achieve risk factor targets.
Improvements are needed to achieve composite risk factor control by comprehensive lifestyle and pharmacological approaches, including new evidence-based therapies for T2DM that reduce CVD outcomes by mechanisms not yet fully understood.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>37193856</pmid><doi>10.1038/s41569-023-00877-z</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1102-7324</orcidid><orcidid>https://orcid.org/0000-0002-1604-2593</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1759-5002 |
| ispartof | Nature reviews cardiology, 2023-10, Vol.20 (10), p.685-695 |
| issn | 1759-5002 1759-5010 1759-5010 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2814816796 |
| source | Alma/SFX Local Collection |
| subjects | 692/163 692/4019 Cardiac Imaging Cardiac Surgery Cardiology Diabetes Epidemiology Medicine Medicine & Public Health Review Article Risk assessment Risk factors |
| title | Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-17T16%3A31%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cardiovascular%20risk%20in%20diabetes%20mellitus:%20epidemiology,%20assessment%20and%20prevention&rft.jtitle=Nature%20reviews%20cardiology&rft.au=Wong,%20Nathan%20D.&rft.date=2023-10-01&rft.volume=20&rft.issue=10&rft.spage=685&rft.epage=695&rft.pages=685-695&rft.issn=1759-5002&rft.eissn=1759-5010&rft_id=info:doi/10.1038/s41569-023-00877-z&rft_dat=%3Cproquest_cross%3E2864401217%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2864401217&rft_id=info:pmid/37193856&rfr_iscdi=true |