心血管疾病预防英文.ppt

PREVENTING CARDIOVASCUAR DISEASE IN TYPE 2 DIABETES: an evidence-based summary W. Kenneth Ward MD and members of the American Diabetes Association (Oregon Affiliate Professional Education Committee) Objectives and Disclosure At the conclusion of the program participants will be able to: Identify which interventions have been shown to reduce or prevent cardiovascular events in patients with Type 2 diabetes. Recognize the magnitude of the benefit of such interventions. Disclosure: W. Kenneth Ward, MD has disclosed that he has no relationship to the manufacturer of any product(s) mentioned in this internet presentation. Slides used with permission of author. All Rights Reserved. Introduction: SECTION 1 CONCLUSIONS (BP and Type 2 diabetes): Summary Studies suggest a benefit of tight control of blood pressure in persons with type 2 diabetes. ACE inhibitors, especially ramipril, reduce the risk of coronary events and progression of atherosclerosis, at least in persons with known vascular disease (and even in those without heart failure). When given as monotherapy, ACE inhibitors (and possibly beta blockers) are superior to calcium channel blockers (CCB) in terms of preventing cardiovascular events in persons with type 2 diabetes. Summary cont. Treatment with aspirin was associated with a substantial reduction in cardiac- and total mortality in type 2 diabetic patients with coronary artery disease. Statin drugs given to patients with type 2 diabetes with known coronary disease have been shown to reduce coronary events, even in those with mild lipid abnormalities. Good glycemic control may have a favorable effect to prevent MI, a finding of borderline significance. An increased risk of CHD was associated with higher egg consumption among diabetic patients. References: Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, Menard J, Rahn KH, Wedel H, Westerling S. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with