Practical prevention and treatment of cardiovascular diseases in patients with diabetesmellitus type 2 in an endocrinological department


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Abstract

Aim. To analyse retrospectively quality of medical correction of modified risk factors (RF) and treatment
of cardiovascular diseases (CVD) in patients with diabetes mellitus type (DM) 2 admitted to specialized
endocrinological departments.
Material and methods. Analysis of medication policy of CVD RF was made retrospectively for 250
patients treated in endocrinological departments of Moscow hospital in 2003.
Results. Arterial hypertension, coronary heart disease were diagnosed in 93.2 and 87.2% examinees.
History of myocardial infarction and brain stroke was in 8.4 and 6% patients. Statins were prescribed
in 2.4% cases. Examination for dyslipidemia was not satisfactory. ACE inhibitors were prescribed in
71.2% patients. Aspirin was prescribed (18%) primarily by the cardiologist.
Conclusion. Quality of medical prophylaxis of CVD RF in DM type 2 patients in the departments does
not satisfy modern clinical recommendations.

References

  1. Amos A., McCarrty D., Zimmer P. The rising global burden of diabetes and its complication; estimates and projections to the year 2010. Diabet. Med. 1997;14 (suppl. 5); S1-S5.
  2. MR FIT Reserch Group. J. A. M. A. 1982; 248: 465-477.
  3. Woodfield S. L., Lundergan С. F., Reiner J. S. et al. Angiographic findings and outcome in diabetic patients treated with thrombolytic therapy for acute myocardial infarction: the GUSTO-I experience. J. Am. Coll. Cardiol. 1996; 28: 1661 - 1669.
  4. Barbash G.I., White N. D., Modern M., van de Werf F. Significance of diabetes mellitus in patients with acute myocardial infarction receiving thrombolytic therapy. J. Am. Coll. Cardiol. 1993; 22: 707-713.
  5. Behar S., Boyko V., Reicher-Reiss H., Goldbourt U. Ten-year survival after acute myocardial infarction: comparison of patients with and without diabetes. Am. Heart J. 1997; 133: 290-296.
  6. Мак K.-H., Moliterno D. J., Granger С. В. et al. Influence of diabetes mellitus on clinical outcome in the thrombolytic era of acute myocardial infarction. J. Am. Coll. Cardiol. 1997; 30: 171-179.
  7. Baigent C., Collins R., Appleby P. et al. ISIS-2: 10 year survival among patients with suspected acute myocardial infarction in randomised comparison of intravenous streptokinase, oral aspirin, both, or neither. Br. Med. J. 1998; 316: 1337-1343.
  8. Miettinen H., Lehto S., Salomaa V. et al J. Impact of diabetes on mortality after the first myocardial infarction. Diabetes Care 1998; 21:69-75.
  9. Berger A. K., Breall J. A., Gersh B. J. et al. Effect of diabetes mellitus and insulin use on survival after acute myocardial infarction in the elderly (the Cooperative Cardiovascular Project).Am. J. Cardiol. 2001; 87: 272-277.
  10. Curb J. D., Pressel S. L., Cutler J. A. et al. Effect of diureticbased antihypertensive treatment on cardiovascular disease riskin older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. J. A. M. A. 1996; 276: 1886-1892.
  11. UK Prospective Diabetes Study (UKPDS) Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39.Br. Med. J. 1998; 317: 713-720.
  12. Haffner S. M., Alexander С. M., Cook T. J. et al. Reduced coronary events in simvastatin-treated patients with coronary heart disease and diabetes or impaired fasting glucose levels: subgroup analyses in the Scandinavian Simvastatin Survival Study. Arch. Intern. Med. 1999; 159: 2661-2667.
  13. Tuomilehto J., Rastenyte D., Birkenhager W. H. et al.Effects of calcium channel blockade in older patients with diabetes and systolic hypertension. Systolic Hypertension in Europe Trial Investigators. N. Eng. J. Med. 1999; 340: 677-684.
  14. Estacio R. O., Jeffers B. W., Gifford N., Schrier R. W. Effect of blood pressure control on diabetic microvascular complications in patients with hypertension and type 2 diabetes. Diabetes Care 2000; 23 (suppl. 2): B54-B64.
  15. Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253-259.
  16. Antiplatelet Trialists' Collaboration. Collaborative overview of randomized trials of antiplatelet therapy I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patient. Br. Med. J. 1994; 308: 81-106.
  17. Kirk J. K., Poirier J. E., Mattox M. G. et al. Compliance with national guidelines in patients with diabetes in a family practice. Clinic. Pharmacotherapy 2002; 22(12): 1541-1546.
  18. Levy D., Savage D. D., Garrison R. J. et al. Echocardiography criteria for left ventricular hypertrophy: the Framingham Heart Study. Am. J. Cardiol. 1987; 59: 956-960.
  19. Lorell B. H., Carabello B. A. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation 2000; 102(4): 470-479.
  20. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. Br. Med. J. 1998; 317: 703-713.
  21. Hansson L., Zanchetti A., Carruthers S. G. et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) ran-domized trial. Lancet 1998; 351: 1755-1762.
  22. Arauz-Pacheco C., Parrott M. A., Raskin P. The treatment of hypertension in adult patients with diabetes. Technical review. Diabetes Care 2002; 25: 134-147.
  23. Executive summary of the Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults. (Adult treatment panel III). J. A. M. A. 2001; 285: 2486-2497.
  24. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 2003; 26: S33- S50.
  25. Steering Committee of the Physicians' Health Study Research Group- Final report on the aspirin component of the ongoing Phvsicians' Health Study. N. Eng. J. Med. 1989; 321: 129- 135.
  26. ETDRS Investigators. Aspirin effects on mortality and morbidity in patients with diabetes mellitus. J. A. M. A. 1992; 268: 1292-1300.
  27. Cotwell J. A. Aspirin therapy in diabetes. (Technical review). Diabetes Care 1997; 20: 1767-1771.
  28. Julius S., Majahalme S., Palatini P. Antihypertensive treatment of patients with diabetes and hypertension. Am. J. Hypertens. 2001; 14: S310-S316.
  29. Kaplan N. M. Management of hypertension in patients with type 2 diabetes mellitus: Guidelines based on current evidence. Ann. Intern. Med. 2001; 135: 1079-1083.
  30. Nichols G. A., Brown J. B. The impact of cardiovascular disease on medical care costs in subjects with and without type 2 diabetes. Diabetes Care 2002; 25: 482-486.
  31. Sueta С. A., Chowdhury M., Boccuzzi S. J. et ai. Analysis of the degree of undertreatment of hyperlipidemia and congestive heart fail-ure secondary to coronary artery disease. Am. J. Cardiol. 1999; 83: 1303-1307.
  32. Reunanen A., Kangas Т., Martikainen J., Klaukka T. Nationwide survey of comorbidity, use, and costs of all medications in Finnish diabetic individuals. Diabetes Care 2000; 23(9): 1265-1271.
  33. Беленное Ю. H., Мареев В. Ю. Как мы лечим больных с сердечно-сосудистыми заболеваниями в реальной клинической практике. Тер. арх. 2003; 86(75): 5-11.
  34. Tatti P., Pahor M., Byington R. P. et al. Outcome results of the Fosinopril Versus Amiodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998; 21(4): 597-603.
  35. Estacio R. Q., Jeffers B. W., Hiatt W. R. et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N. Eng. J. Med. 1998; 338: 645-652.
  36. Capes S. E., Gerstein H. C., Negassa A., Yusuf S. Enalapril prevents clinical proteinuria in diabetic patients with low ejection fraction. Diabetes Care 2000; 23(3): 377-380.
  37. Niskanen L., Hedner I., Hansson L. et al. Reduced cardiovascular morbidity and mortality in hypertensive diabetic patients on first-line therapy with an ACE inhibitor compared with a diuretic/p-blocker-based treatment regimen. A subanalysis of the captopril prevention project. Diabetes Care 2001; 24: 2091-2096.
  38. Fogari R., Mugellini A., Zoppi A. et al. Losartan and perindopril effects on plasma plasminogen activator inhibitor-1 and fibrinogen in hypertensive type 2 diabetic patients. Am. J. Hypertens. 2002; 15(4, pt 1): 316-320.
  39. Rolka D. В., Fagot-Campagna A., Narayan К. М. V. Aspirin use among adults with diabetes. Estimates from the Third National Health and Nutrition Examination Survey. Diabetes Care 2001; 24: 197-201.
  40. Paragon J. J., Waite N. M., Hobson E. H. et al. Improving aspirin prophylaxis in a primarey care diabetic population. Pharmacotherapy 2003; 23(1): 73-79.
  41. Phillips L. S., Branch W. Т., Cook С. В. et al. Clinical inertia. Ann. Intern. Med. 2001; 135(9): 825-834.
  42. Hill M. N., Miller N. H. A call for multidisciplinary team approaches. Circulation 1996; 93: 4-6.
  43. Gaede P., Vedel P., Larsen N. et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N.Eng. J. Med. 2003; 348(5): 383-393.

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