糖尿病的心血管预防。是说中度风险还是中度风险合适?

IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE
Sergio Martínez-Hervás , José T. Real , Rafael Carmena , Juan F. Ascaso
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引用次数: 0

摘要

糖尿病,特别是2型糖尿病,被认为是动脉粥样硬化性心血管疾病(ASCVD)的危险情况。2型糖尿病患者ASCVD的死亡率比一般人群高3倍,这是由于高血糖和其他心血管危险因素(如动脉粥样硬化性血脂异常)的频繁关联。许多科学协会已经根据3度(中度、高和非常高)建立了糖尿病ASCVD的风险分类。血脂异常控制的目标是明确定义和公认的,并且根据先前确定的心血管风险而变化。对于中度或中度风险,指南建议进行低强度干预,维持LDL-C水平
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevención cardiovascular en la diabetes mellitus. ¿Es adecuado hablar de riesgo moderado o intermedio?

Diabetes, especially type 2, is considered a risk situation for atherosclerotic cardiovascular disease (ASCVD). Subjects with diabetes type 2 have a mortality rate due to ASCVD 3 times higher than that found in the general population, attributed to hyperglycemia and the frequent association of other cardiovascular risk factors, such as atherogenic dyslipidemia.

Numerous scientific societies have established a risk classification for ASCVD in diabetes based on 3 degrees (moderate, high and very high). The objectives of dyslipidemia control are clearly defined and accepted, and vary depending on the previously established cardiovascular risk.

In moderate or intermediate risk, the guidelines propose a less intensive intervention, maintaining LDL-C levels < 100 mg/dL and NO-HDL-C levels < 130 mg/dL, and waiting 10 years until reaching the high-risk category to initiate more intensive treatment. However, during the decade of follow-up recommended in the guidelines, cholesterol deposition in the arterial wall increases, facilitating the development of an unstable and inflammatory atheromatous plaque, and the development of ASCVD. Alternatively, diabetes could be considered from the outset to be a high-risk situation and the goal should be LDL-C < 70 mg/dL. Furthermore, maintaining LDL-C levels < 70 mg/dL contributes to reducing and stabilizing atheromatous plaque, avoiding or reducing mortality episodes due to ASCVD during those years of diabetes evolution.

Should we maintain the proposed objectives in subjects with diabetes and moderate risk for a decade until reaching the high cardiovascular risk phase or, on the contrary, should we adopt a more intensive stance from the beginning seeking to reduce cardiovascular risk in the majority of patients with diabetes? Is it better to wait or prevent with effective therapeutic measures from the first moment?

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来源期刊
Clinica e Investigacion en Arteriosclerosis
Clinica e Investigacion en Arteriosclerosis PERIPHERAL VASCULAR DISEASE-
CiteScore
3.20
自引率
6.20%
发文量
44
审稿时长
40 days
期刊介绍: La publicación idónea para acceder tanto a los últimos originales de investigación como a formación médica continuada sobre la arteriosclerosis y su etiología, epidemiología, fisiopatología, diagnóstico y tratamiento. Además, es la publicación oficial de la Sociedad Española de Arteriosclerosis.
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