cardiovascular disease treatment

People who have type 2 diabetes and coronary artery disease (CAD) may need “more aggressive” treatment according to new guidance in the US.

The American Heart Association has put out a scientific statement which lays out the latest treatments currently available for people who have both health conditions. The organisation has also detailed the pros and cons of taking certain common medications.

The document refers to the type 2 diabetes treatments metformin, sodium-glucose co-transporter inhibitors (SGLT2 inhibitors) and glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) while also discussing how these drugs have fared among people with CAD in studies.

Other highlights of the statement include guidance on blood pressure management, lipid management, antiplatelet therapies, and lifestyle modifications.

Dr Suzanne Arnold, chair of the writing group for the scientific statement, associate professor of medicine at the University of Missouri Kansas City, and a cardiologist at Saint Luke’s Mid America Heart Institute, said: “Recent scientific studies have shown that people with type 2 diabetes may need more aggressive or different medical and surgical treatments compared to people with CAD who do not have type 2 diabetes.

“What we’ve learned in the past decade is how you control glucose levels has a huge influence on cardiovascular risk. Lowering blood sugars to a certain level is not sufficient.

“There are now more options for controlling glucose in people with type 2 diabetes, and each patient should be evaluated for their personal risk of cardiovascular disease, stroke and kidney disease. This combined health information as well as the patient’s age should be used to determine the appropriate therapies to lower glucose.”

The statement was developed on behalf of the American Heart Association’s Council on Lifestyle and Cardiometabolic Health and Council on Clinical Cardiology.

Dr Arnold said that although medication is “very important” there is no “pill substitute for a healthy lifestyle”.

She added: “No matter what new medicines there are, a heart-healthy diet, achieving and maintaining a healthy weight, regular physical activity and treating sleep disorders remain the major cornerstones of treatment” for type 2 diabetes and coronary artery disease.

To read the statement in full, click here

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