RESUMO
La presencia de diabetes (tipos 1 y 2) incrementa el riesgo de enfermedad cardiovascular aterosclerótica. A pesar de un control metabólico adecuado y un tratamiento de los factores de riesgo vascular hasta alcanzar los objetivos recomendados por las guías clínicas, el riesgo cardiovascular residual de algunos pacientes con diabetes puede ser muy elevado. Es necesario por ello estratificar de la forma más precisa posible el riesgo vascular del paciente individual. Estrategias consolidadas para mejorar el pronóstico de los pacientes son la reducción agresiva del colesterol LDL, el control de la presión arterial, la consecución del mejor control posible de la HbA1c, sin inducir hipoglucemias, la utilización de fármacos hipoglucemiantes con beneficio cardiovascular y el empleo de antiagregantes en los pacientes de mayor riesgo inicial. Estrategias emergentes para pacientes con riesgo muy alto o extremo serían la utilización de fármacos destinados a reducir las lipoproteínas ricas en triglicéridos y la inflamación
Presence of diabetes (types 1 and 2) increases the risk of atherosclerotic cardiovascular disease. Despite adequate metabolic control and treatment of vascular risk factors until the goals recommended by the clinical practice guidelines are achieved, residual cardiovascular risk may be very high in some patients with diabetes. Stratifying the vascular risk for each patient as precisely as possible is therefore necessary. Consolidated strategies to improve patient prognosis include aggressive reduction of LDL cholesterol, blood pressure control, achievement of the best HbA1c control possible without inducing hypoglycemia, use of hypoglycemic drugs shown to have cardiovascular benefits, and use of platelet aggregation inhibitors in patients with greater initial risk. Emerging strategies for patients with very high or extreme risk would include use of drugs intended to decrease triglyceride-rich lipoproteins and inflammation
Assuntos
Humanos , Diabetes Mellitus/fisiopatologia , Complicações do Diabetes , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Medição de Risco , Fatores de RiscoRESUMO
Presence of diabetes (types 1 and 2) increases the risk of atherosclerotic cardiovascular disease. Despite adequate metabolic control and treatment of vascular risk factors until the goals recommended by the clinical practice guidelines are achieved, residual cardiovascular risk may be very high in some patients with diabetes. Stratifying the vascular risk for each patient as precisely as possible is therefore necessary. Consolidated strategies to improve patient prognosis include aggressive reduction of LDL cholesterol, blood pressure control, achievement of the best HbA1c control possible without inducing hypoglycemia, use of hypoglycemic drugs shown to have cardiovascular benefits, and use of platelet aggregation inhibitors in patients with greater initial risk. Emerging strategies for patients with very high or extreme risk would include use of drugs intended to decrease triglyceride-rich lipoproteins and inflammation.
Assuntos
Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Medição de Risco , Fatores de RiscoRESUMO
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