会议预告

临床指南

代谢综合征患者的心血管病疾病和2型糖尿病的一级预防

 

代谢综合征患者的心血管病疾病和2型糖尿病的一级预防:内分泌学会临床实践指南

Primary Prevention of Cardiovascular Disease and Type 2 Diabetes in Patients at

Metabolic Risk:An Endocrine Society Clinical Practice Guideline

 

 

Table of Contents
Summary of Recommendations
Method of Development of Evidence-Based Guidelines
Definition and Diagnosis
Absolute Risk Assessment
Treatment to Prevent Atherosclerotic CVD (Especially CHD and Stroke) 
Treatment to Prevent T2DM
Appendix 
References
Order Form
Reprint Information, Questions & Correspondences
 
Abstract

 

Objective: The objective was to develop clinicalpractice guidelines for the primary prevention ofcardiovascular disease (CVD) and type 2 diabetesmellitus (T2DM) in patients at metabolic risk.

 
Participants: The Task Force was composed of a chair,selected by the Clinical Guidelines Subcommittee(CGS) of The Endocrine Society, six additionalexperts, one methodologist, and a medical writer.The Task Force received no corporate funding orremuneration.
 
Evidence: Systematic reviews of available evidencewere used to formulate the key treatment andprevention recommendations. We used the Gradingof Recommendations, Assessment, Development,and Evaluation (GRADE) group criteria todescribe both the quality of evidence and thestrength of recommendations. We used ‘recommend’for strong recommendations and ‘suggest’ for weakrecommendations.
 
Consensus Process: Consensus was guided bysystematic reviews of evidence and discussions duringone group meeting, several conference calls, ande-mail communications. The drafts prepared by thetask force with the help of a medical writer werereviewed successively by The Endocrine Society’sCGS, Clinical Affairs Committee (CAC), andCouncil. The version approved by the CGS andCAC was placed on The Endocrine Society’s Website for comments by members. At each stage ofreview, the Task Force received written commentsand incorporated needed changes.
 
Conclusions: Healthcare providers should incorporateinto their practice concrete measures to reduce therisk of developing CVD and T2DM. These includethe regular screening and identification of patients atmetabolic risk (at higher risk for both CVD andT2DM) with measurement of blood pressure, waistcircumference, fasting lipid profile, and fastingglucose. All patients identified as having metabolicrisk should undergo 10-yr global risk assessment foreither CVD or coronary heart disease. This scoringwill determine the targets of therapy for reduction ofapolipoprotein B-containing lipoproteins. Carefulattention should be given to the treatment ofelevated blood pressure to the targets outlined in thisguideline. The prothrombotic state associated withmetabolic risk should be treated with lifestylemodification measures and in appropriate individualswith low-dose aspirin prophylaxis. Patients withprediabetes (impaired glucose tolerance or impairedfasting glucose) should be screened at 1- to 2-yrintervals for the development of diabetes with eithermeasurement of fasting plasma glucose or a 2-h oralglucose tolerance test. For the prevention of CVDand T2DM, we recommend that priority be given tolifestyle management. This includes antiatherogenicdietary modification, a program of increased physicalactivity, and weight reduction. Efforts to promotelifestyle modification should be considered animportant component of the medical management ofpatients to reduce the risk of both CVD and T2DM.
 

 

 

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