Diabetes Q&A

ADA/AHA: Updated Guidelines on CVD Prevention in Diabetes

The American Heart Association and American Diabetes Association have released a new scientific statement reviewing current literature and presenting new guidelines and clinical targets for the prevention of cardiovascular disease (CVD) in patients with type 2 diabetes.

The new statement updates the 2007 guideline in response to new data that has “changed the clinical practice of CVD risk management in diabetes mellitus.”
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Key recommendations include:

  • Clinicians should inform patients with diabetes who are overweight that lifestyle changes can result in a sustainable 3%-5% weight loss.
  • Bariatric surgery can improve outcomes in patients with a BMI of 35 or higher with obesity-related conditions.
  • Low-dose aspirin is appropriate in patients with 10-year CVD risk of at least 10% and in patients with diabetes mellitus with 10-year CVD risk of 5%-10%.
  • On average, patients should aim for an A1c level of 7.0% or less, although higher and lower targets are appropriate in certain situations.
  • 140/90 mm Hg is a reasonable blood pressure goal for most patients.
  • Statins should be prescribed to patients between 40 and 75 years old with LDL cholesterol levels of 70-189 mg/dL.

“As a scientific community, our goal is better primary prevention of CVD in all patients with diabetes mellitus.”

“Considerable work remains to be done to enhance our understanding of how to more effectively prevent CVD in patients with type 2 diabetes mellitus,” they concluded.

The complete statement is published in Diabetes Care and Circulation.

—Michael Potts

Fox CS, Golden SH, Anderson C, et al. Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: a scientific statement from the American Heart Association and the American Diabetes Association. August 5, 2015 [epub ahead of print] DOI: 10.2337/dci15-0012.