Professor and Director Heart Disease Prevention Program Division of Cardiology. President, American Society for Preventive Cardiology

Diabetes and Cardiometabolic Syndrome: Epidemiology and Management for Prevention of CVD Nathan D. Wong, PhD, FACC, FAHA N h D W PhD FACC FAHA Profess...
Author: Kellie Poole
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Diabetes and Cardiometabolic Syndrome: Epidemiology and Management for Prevention of CVD Nathan D. Wong, PhD, FACC, FAHA N h D W PhD FACC FAHA Professor and Director H Heart Disease Prevention Program Di P i P Division of Cardiology U i University of California, Irvine i f C lif i I i President, American Society for Preventive  C di l Cardiology

Presentation Objectives • Review the epidemiology implicating metabolic syndrome and diabetes in cardiovascular risk • Discuss the clinical trial evidence for the y management, g g glycemic, y role of lifestyle lipid, and blood pressure control. • Address the ABCs of lifestyle y and clinical management of metabolic syndrome and diabetes aimed to reduce cardiovascular di disease risk. i k

Obesity Trends* Among U.S. Adults:  BRFSS 2008 BRFSS ‐

No Data

30% %

Abdominal Adiposity Is Associated With Increased Risk of Diabetes With Increased Risk of Diabetes Relative Risk of Diiabetes

25

P value for trend =25 Al-Nozha et al. (Saudi Med J 2004): 26.2% males, 21.5% females (p75% of all hospitalizations for diabetic complications li ti

• 50% of patients with type 2 diabetes have preexisting CAD. (This number may be less now that more younger people are diagnosed with diabetes ) diabetes.)

• 1/3 of patients presenting with myocardial infarction have undiagnosed diabetes mellitus Lewis GF. Can J Cardiol. 1995;11(suppl C):24C-28C Norhammar A, et.al. Lancet 2002;359;2140-2144

Risk of Cardiovascular Events in Patients  with Diabetes:  Diabetes: Framingham Diabetes: Framingham Study Framingham Study Study _________________________________________________________________

Cardiovascular Event

Age-adjusted Age adjusted Biennial Rate Per 1000 Men Women

Age-adjusted Risk Ratio Men Women

Coronary Disease Stroke Peripheral Artery Dis. Cardiac Failure All CVD Events

39 15 18 23 76

1.5** 2.9*** 3.4*** 4 4*** 4.4*** 2.2***

21 6 18 21 65

2.2*** 2.6*** 6.4*** 7 7.8*** 8*** 3.7***

_________________________________________________________________

Subjects 35-64 36-year Follow-up

**P20% 10-year risk):

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