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1.
Aten Primaria ; 48(5): 325-36, 2016 May.
Artigo em Espanhol | MEDLINE | ID: mdl-26031458

RESUMO

The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Angiopatias Diabéticas/prevenção & controle , Cardiomiopatias Diabéticas/prevenção & controle , Doenças Cardiovasculares/etiologia , Angiopatias Diabéticas/etiologia , Cardiomiopatias Diabéticas/etiologia , Dieta Saudável , Exercício Físico , Humanos , Hiperlipidemias/complicações , Estilo de Vida , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Fatores de Risco , Prevenção do Hábito de Fumar
2.
Clin Investig Arterioscler ; 30(3): 137-153, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29754804

RESUMO

This document is an update to the clinical practice recommendations for the management of cardiovascular risk factors in diabetes mellitus. The consensus is made by members of the Cardiovascular Risk Group of the Spanish Diabetes Society. We have proposed and updated interventions on lifestyle, pharmacological treatment indicated to achieve therapeutic objectives according to the levels of HbA1c, degree of obesity, hypertension, hyperlipidemia, heart failure, platelet antiagregation, renal insufficiency, and diabetes in the elderly, as well as new biomarkers of interest in the evaluation of cardiovascular risk in individuals with diabetes mellitus. The work is an update of the interventions and therapeutic objectives in addition, it is noted the need for the inclusion of specialists in Endocrinology, Metabolism and Nutrition in Cardiac Rehabilitation Units for the control and monitoring of this population.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Angiopatias Diabéticas/prevenção & controle , Cardiomiopatias Diabéticas/prevenção & controle , Idoso , Biomarcadores/metabolismo , Doenças Cardiovasculares/etiologia , Diabetes Mellitus/fisiopatologia , Diabetes Mellitus/terapia , Humanos , Estilo de Vida , Fatores de Risco , Espanha
3.
Med Clin (Barc) ; 148(3): 139.e1-139.e15, 2017 Feb 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27993410

RESUMO

Cardiovascular disease is a chronic disorder which is usually already at an advanced stage when the first symptoms develop. The fact that the initial clinical presentation can be lethal or highly incapacitating emphasizes the need for primary and secondary prevention. It is estimated that the ratio of patients with good adherence to secondary prevention of cardiovascular disease is low and also decreases gradually over time. The Polypill for secondary prevention of cardiovascular disease is the first fixed-dose combination therapy of salicylic acid, atorvastatin and ramipril approved in Spain. The purpose of this consensus document was to define and recommend, through the evidence available in the literature and clinical expert opinion, the impact of treatment adherence in the secondary prevention of cardiovascular disease and the use of the Polypill in daily clinical practice as part of a global strategy including adjustments in patient lifestyle. A RAND/UCLA methodology based on scientific evidence, as well as the collective judgment and clinical expertise of an expert panel was used for this assessment. As a result, a final report of recommendations on the impact of the lack of adherence to treatment of secondary prevention of cardiovascular disease and the effect of using a Polypill in adherence of patients was produced. The recommendations included in this document have been addressed to all those specialists, cardiologists, internists and primary care physicians with competence in prescribing and monitoring patients with high and very high cardiovascular risks.


Assuntos
Atorvastatina/administração & dosagem , Fármacos Cardiovasculares/administração & dosagem , Doenças Cardiovasculares/prevenção & controle , Adesão à Medicação , Ramipril/administração & dosagem , Ácido Salicílico/administração & dosagem , Prevenção Secundária/métodos , Atorvastatina/uso terapêutico , Fármacos Cardiovasculares/uso terapêutico , Combinação de Medicamentos , Humanos , Ramipril/uso terapêutico , Ácido Salicílico/uso terapêutico
4.
Clin Investig Arterioscler ; 27(4): 181-92, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-25825221

RESUMO

The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Fatores de Risco , Abandono do Hábito de Fumar/métodos , Espanha
5.
Aten. prim. (Barc., Ed. impr.) ; 48(5): 325-336, mayo 2016. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-151919

RESUMO

El presente documento actualiza las recomendaciones de práctica clínica del manejo de los factores de riesgo cardiovascular (FRCV) en la diabetes mellitus (DM). Es un consenso médico realizado por un panel de expertos independiente de la Sociedad Española de Diabetes (SED). Se han propuesto y actualizado varios consensos de diferentes sociedades científicas o médicas con el fin de mejorar los resultados terapéuticos. La valoración del RCV en la población general puede carecer de sensibilidad para la evaluación individual en determinados grupos de riesgo como los diabéticos. Se revisan los factores de riesgo tradicionales y no tradicionales, así como las estrategias de intervención para el control de los FRCV en los pacientes diabéticos como la dieta, el control ponderal, el ejercicio físico, los hábitos tóxicos, el control glucémico, tensional y lipídico, así como la antiagregación plaquetaria. Confiamos en que estas pautas ayuden a los médicos en la toma de decisiones en su actividad asistencial. Se expone una actualización de los conceptos más relevantes y de mayor interés clínico-práctico y, a su vez realista, para reducir el RCV de los diabéticos como se venía haciendo regularmente por parte del Grupo de Enfermedad Cardiovascular de la SED


The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics


Assuntos
Humanos , Masculino , Feminino , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/prevenção & controle , Diabetes Mellitus/terapia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/terapia , Fatores de Risco , Estilo de Vida , Atividade Motora/fisiologia , Dieta Mediterrânea , Prevenção de Doenças , Estudos Epidemiológicos , Exercício Físico/fisiologia , Adesão à Medicação , Estudos Prospectivos , Guias de Prática Clínica como Assunto/normas , Consenso , Espanha
6.
Clín. investig. arterioscler. (Ed. impr.) ; 30(3): 137-153, mayo-jun. 2018. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-175429

RESUMO

El presente documento es una actualización de las recomendaciones de práctica clínica para el manejo de los factores de riesgo cardiovascular en la diabetes mellitus. Este consenso está elaborado por los miembros del Grupo de Riesgo Cardiovascular de la Sociedad Española de Diabetes (SED). Se han propuesto y actualizado las intervenciones sobre el estilo de vida, tratamiento farmacológico indicado para alcanzar los objetivos terapéuticos según los niveles de HbA1c, grado de obesidad, hipertensión arterial, hiperlipemia, insuficiencia cardiaca, antiagregación plaquetaria, insuficiencia renal y diabetes en el anciano, así como nuevos biomarcadores de interés en la evaluación del riesgo cardiovascular. El trabajo es una actualización de las intervenciones y objetivos terapéuticos; además, se señala la necesidad de la inclusión de los especialistas en Endocrinología, Metabolismo y Nutrición en las Unidades de Rehabilitación Cardiaca para el control y seguimiento de esta población


This document is an update to the clinical practice recommendations for the management of cardiovascular risk factors in diabetes mellitus. The consensus is made by members of the Cardiovascular Risk Group of the Spanish Diabetes Society. We have proposed and updated interventions on lifestyle, pharmacological treatment indicated to achieve therapeutic objectives according to the levels of HbA1c, degree of obesity, hypertension, hyperlipidemia, heart failure, platelet antiagregation, renal insufficiency, and diabetes in the elderly, as well as new biomarkers of interest in the evaluation of cardiovascular risk in individuals with diabetes mellitus. The work is an update of the interventions and therapeutic objectives in addition, it is noted the need for the inclusion of specialists in Endocrinology, Metabolism and Nutrition in Cardiac Rehabilitation Units for the control and monitoring of this population


Assuntos
Humanos , Idoso , Complicações do Diabetes/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/fisiopatologia , Fatores de Risco , Estilo de Vida , Obesidade Mórbida/cirurgia , Glicemia/análise , Hipertensão , Hiperlipidemias/tratamento farmacológico , Insuficiência Renal Crônica/tratamento farmacológico , Idoso
7.
Med. clín (Ed. impr.) ; 148(3): 139.e1-139.e15, feb. 2017. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-160057

RESUMO

La enfermedad cardiovascular suele estar en fase avanzada cuando aparecen los primeros síntomas. El hecho de que la presentación clínica inicial pueda ser letal o altamente incapacitante enfatiza la necesidad de la prevención primaria y secundaria. Se estima que la proporción de pacientes con buena adherencia en prevención secundaria de la enfermedad cardiovascular es baja y disminuye progresivamente en el tiempo. La Polypill para la prevención cardiovascular secundaria es el primer tratamiento combinado en dosis fija de ácido acetilsalicílico, atorvastatina y ramipril aprobada en España. El propósito de este documento de consenso fue definir y recomendar, a través de la evidencia en la literatura y la opinión clínica de expertos, el impacto de la adherencia al tratamiento de prevención cardiovascular secundaria y el uso en la práctica clínica de la Polypill integrado en una estrategia global que incluye modificaciones en el estilo de vida. Para la realización de este consenso se ha utilizado la metodología RAND/UCLA que está basada en la evidencia científica y en el juicio colectivo y experiencia clínica de un panel de expertos. Como resultado se ha elaborado un informe final de recomendaciones sobre el impacto de la falta de adherencia al tratamiento de la prevención cardiovascular secundaria y el efecto del uso de una Polypill en la adherencia terapéutica de los pacientes. Las recomendaciones de este documento se orientan a todos aquellos especialistas, cardiólogos, médicos internistas y médicos de atención primaria con competencia en la prescripción y seguimiento de los pacientes de alto y muy alto riesgo cardiovascular y que requieran prevención secundaria (AU)


Cardiovascular disease is a chronic disorder which is usually already at an advanced stage when the first symptoms develop. The fact that the initial clinical presentation can be lethal or highly incapacitating emphasizes the need for primary and secondary prevention. It is estimated that the ratio of patients with good adherence to secondary prevention of cardiovascular disease is low and also decreases gradually over time. The Polypill for secondary prevention of cardiovascular disease is the first fixed-dose combination therapy of salicylic acid, atorvastatin and ramipril approved in Spain. The purpose of this consensus document was to define and recommend, through the evidence available in the literature and clinical expert opinion, the impact of treatment adherence in the secondary prevention of cardiovascular disease and the use of the Polypill in daily clinical practice as part of a global strategy including adjustments in patient lifestyle. A RAND/UCLA methodology based on scientific evidence, as well as the collective judgment and clinical expertise of an expert panel was used for this assessment. As a result, a final report of recommendations on the impact of the lack of adherence to treatment of secondary prevention of cardiovascular disease and the effect of using a Polypill in adherence of patients was produced. The recommendations included in this document have been addressed to all those specialists, cardiologists, internists and primary care physicians with competence in prescribing and monitoring patients with high and very high cardiovascular risks (AU)


Assuntos
Humanos , Masculino , Feminino , Doenças Cardiovasculares/prevenção & controle , Prevenção Secundária/métodos , Prevenção Secundária/tendências , Adesão à Medicação , Terapia Combinada/métodos , Terapia Combinada , Aspirina/uso terapêutico , Atorvastatina/uso terapêutico , Ramipril/uso terapêutico , Indicadores de Morbimortalidade , Medicina Baseada em Evidências/métodos
8.
Clín. investig. arterioscler. (Ed. impr.) ; 27(4): 181-192, jul.-ago. 2015. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-142015

RESUMO

El presente documento actualiza las recomendaciones de práctica clínica del manejo de los factores de riesgo cardiovascular (FRCV) en la diabetes mellitus (DM). Es un consenso médico realizado por un panel de expertos independiente de la Sociedad Española de Diabetes (SED). Se han propuesto y actualizado varios consensos de diferentes sociedades científicas o médicas con el fin de mejorar los resultados terapéuticos. La valoración del RCV en la población general puede carecer de sensibilidad para la evaluación individual en determinados grupos de riesgo como los diabéticos. Se revisan los factores de riesgo tradicionales y no tradicionales, así como las estrategias de intervención para el control de los FRCV en los pacientes diabéticos como la dieta, el control ponderal, el ejercicio físico, los hábitos tóxicos, el control glucémico, tensional y lipídico, así como la antiagregación plaquetaria. Confiamos en que estas pautas ayuden a los médicos en la toma de decisiones en su actividad asistencial. Se expone una actualización de los conceptos más relevantes y de mayor interés clínico-práctico y, a su vez realista, para reducir el RCV de los diabéticos como se venía haciendo regularmente por parte del Grupo de Enfermedad Cardiovascular de la SED


The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics


Assuntos
Feminino , Humanos , Masculino , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Anormalidades Cardiovasculares/genética , Anormalidades Cardiovasculares/metabolismo , Dieta para Diabéticos/classificação , Dieta para Diabéticos/métodos , Pressão Arterial/genética , Preparações Farmacêuticas/administração & dosagem , Diabetes Mellitus/genética , Diabetes Mellitus/metabolismo , Anormalidades Cardiovasculares/complicações , Anormalidades Cardiovasculares/patologia , /normas , Dieta para Diabéticos/instrumentação , Dieta para Diabéticos , Pressão Arterial/fisiologia , Preparações Farmacêuticas/provisão & distribuição
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