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

• Autores: Tabesh, Maryam; Magliano, D. J.; Tanamas, S. K.; Surmont, F.; Bahendeka, S.; Chiang, C. E.; Elgart, Jorge Federico; Gagliardino, Juan Jose; Kalra, Sanjay; Krishnamoorthy, S.; Luk, Andrea; Maegawa, H.; Motala, A. A.; Pirie, F.; Ramachandran, A.; Tayeb, K.; Vikulova, O.; Wong, J.; Shaw, J. E.
• Año de publicación: 2019
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: cardiovascular; diabetes; North America; Western Europe
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

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.
Fil: Tabesh, M.. Monash University; Australia
Fil: Magliano, D.J.. Baker Heart And Diabetes Institute; Australia
Fil: Tanamas, S.K.. Baker Heart And Diabetes Institute; Australia
Fil: Surmont, F.. Monash University; Australia
Fil: Bahendeka, S.. Baker Heart And Diabetes Institute; Australia
Fil: Chiang, C.-E.. Astrazeneca;
Fil: ELGART, JORGE FEDERICO. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico La Plata. Centro de Endocrinología Experimental y Aplicada (i); Argentina
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico La Plata. Centro de Endocrinología Experimental y Aplicada (i); Argentina
Fil: Kalra, S.. Centro de Endocrinología Experimental y Aplicada (conicet- Universidad Nacional de la Plata); Argentina
Fil: Krishnamoorthy, S.. Centro de Endocrinología Experimental y Aplicada (conicet- Universidad Nacional de la Plata); Argentina
Fil: Luk, A.. Bharti Hospital; India
Fil: Maegawa, H.. Dr. A Ramachandran's Diabetes Hospitals; India
Fil: Motala, A.A.. Prince Of Wales Hospital Hong Kong; Hong Kong
Fil: Pirie, F.. Shiga University Of Medical Science;
Fil: Ramachandran, A.. University Of Kwazulu-natal;
Fil: Tayeb, K.. University Of Kwazulu-natal;
Fil: Vikulova, O.. Dr. A Ramachandran's Diabetes Hospitals; India
Fil: Wong, J.. Al Noor Specialist Hospital;
Fil: Shaw, J.E.. Endocrinology Research Centre;