Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015

Autor: Olga K. Vikulova, Dianna J. Magliano, Andrea O.Y. Luk, A. Ramachandran, Fraser J. Pirie, Chern En Chiang, Sanjay Kalra, Juan José Gagliardino, Filip Surmont, Jorge Federico Elgart, Satheesh Krishnamoorthy, Maryam Tabesh, Jonathan E. Shaw, Stephanie K. Tanamas, Jencia Wong, Hiroshi Maegawa, Ayesha A. Motala, K. Tayeb, Silver Bahendeka
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Epidemiology
Endocrinology
Diabetes and Metabolism
Enfermedad cardiovascular
Salud
Type 2 diabetes
Medicina Clínica
chemistry.chemical_compound
0302 clinical medicine
Endocrinology
Endocrinología y Metabolismo
Western europe
purl.org/becyt/ford/3.2 [https]
Endocrinología
030212 general & internal medicine
Complicaciones de la Diabetes
Research Articles
Aspirin
diabetes
cardiovascular
Middle Aged
Europe
Tolerability
Hypertension
Female
purl.org/becyt/ford/3 [https]
medicine.drug
medicine.medical_specialty
CIENCIAS MÉDICAS Y DE LA SALUD
Medicina
030209 endocrinology & metabolism
03 medical and health sciences
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Humans
Thiazide
Antihypertensive Agents
Aged
Dyslipidemias
Cholesterol
business.industry
Calcium channel
medicine.disease
Health Surveys
North america
Blood pressure
chemistry
Diabetes Mellitus
Type 2
Ciencias Médicas
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Diabetic Angiopathies
Research: Epidemiology
Zdroj: SEDICI (UNLP)
Universidad Nacional de La Plata
instacron:UNLP
CONICET Digital (CONICET)
Consejo Nacional de Investigaciones Científicas y Técnicas
instacron:CONICET
Diabetic Medicine
Popis: Aim: Optimal treatment of cardiovascular disease is essential to decrease mortality among people with diabetes, but information is limited on how actual treatment relates to guidelines. We analysed changes in therapeutic approaches to anti-hypertensive and lipid-lowering medications in people with Type 2 diabetes from 2006 and 2015. Methods: Summary data from clinical services in seven countries outside North America and Western Europe were collected for 39 684 people. Each site summarized individual-level data from outpatient medical records for 2006 and 2015. Data included: demographic information, blood pressure (BP), total cholesterol levels and percentage of people taking statins, anti-hypertensive medication (angiotensin-converting enzyme inhibitors, calcium channel blockers, angiotensin II receptor blockers, thiazide diuretics) and antiplatelet drugs. Results: From 2006 to 2015, mean cholesterol levels decreased in six of eight sites (range: −0.5 to −0.2), whereas the proportion with BP levels > 140/90 mmHg increased in seven of eight sites. Decreases in cholesterol paralleled increases in statin use (range: 3.1 to 47.0 percentage points). Overall, utilization of anti-hypertensive medication did not change. However, there was an increase in the use of angiotensin II receptor blockers and a decrease in angiotensin-converting enzyme inhibitors. The percentage of individuals receiving calcium channel blockers and aspirin remained unchanged. Conclusions: Our findings indicate that control of cholesterol levels improved and coincided with increased use of statins. The percentage of people with BP > 140/90 mmHg was higher in 2015 than in 2006. Hypertension treatment shifted from using angiotensin-converting enzyme inhibitors to angiotensin II receptor blockers. Despite the potentially greater tolerability of angiotensin II receptor blockers, there was no associated improvement in BP levels.
Centro de Endocrinología Experimental y Aplicada
Databáze: OpenAIRE
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