Principles of cardiovascular risk management in perimenopausal women with type 2 diabetes

Abstract

Cardiovascular disease is the leading cause of death in patients with diabetes mellitus. It has been established that the period of menopause, associated with an increase in age and a change in the metabolic background, increases the risk of developing cardiovascular diseases in women with diabetes mellitus. Despite tentative expectations, a number of studies have shown conflicting evidence regarding the beneficial effects of menopausal hormone therapy on CV risk markers in diabetes mellitus. In this connection, therapy with hormonal preparations containing estrogen is currently not recommended for the prevention of cardiovascular diseases in the absence of specific indications. At the same time, estrogen therapy can be used in this group to minimize menopausal symptoms. At the same time, the risk of adverse events associated with the use of menopausal hormone therapy can be estimated using calculation methods for determining cardiovascular risk and breast cancer risk using specific calculators, especially in the group of women with type 2 diabetes.The main principles of cardiovascular risk management continue to focus on lifestyle modification and achieving target levels of cardiovascular risk parameters such as lipid levels, glycemia, and blood pressure. The use of pharmacological therapy to address these risk factors, especially some pleiotropic antihyperglycemic drugs, may provide additional options for the prevention of cardiovascular disease.