Evidence-Based Cardiovascular Risk Management in Diabetes

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
Arshag D Mooradian

Abstract

Multipronged risk management in diabetes has contributed to the recent decline in cardiovascular mortality. Few antihyperglycemic drugs have been conclusively shown to have cardioprotective effects. These include metformin, liraglutide, semaglutide, dulaglutide, and sodium-glucose cotransporter-2 inhibitors. Statins are the cornerstone of treatment for people with established coronary artery disease (CAD) or at risk of CAD. In patients with persistent low-density lipoprotein cholesterol (LDL-C) levels > 70 mg/dL, the addition of ezetimibe or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors is recommended. In general, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers should be included in the treatment regimen. The goal is to have blood pressure < 140/90 mmHg, whereas a lower goal of < 130/80 mmHg is recommended in patients with CAD or proteinuria (> 1 g/day). Aspirin antiplatelet therapy should be restricted for people with established CAD or those with multiple CAD risk factors. While antiobesity medications have a modest role in managing obesity, bariatric surgery in people with body mass index (BMI) ≥ 40 or ≥ 35 with comorbidities can substantially affect quality of life and may reduc...Continue Reading

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Citations

Nov 27, 2019·Pharmaceutics·Mohamed A MorsyTamer M Shehata
Feb 6, 2020·Drugs·Julien J Feghaly, Arshag D Mooradian
Jun 12, 2021·European Journal of Pharmacology·Poonam KapadiaArshag D Mooradian

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