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 José; 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
2018
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
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
Materia
Salud
Medicina
Ciencias Médicas
Enfermedad cardiovascular
Complicaciones de la Diabetes
North america
Western europe
Endocrinología
Nivel de accesibilidad
acceso abierto
Condiciones de uso
http://creativecommons.org/licenses/by-nc/4.0/
Repositorio
SEDICI (UNLP)
Institución
Universidad Nacional de La Plata
OAI Identificador
oai:sedici.unlp.edu.ar:10915/96677

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repository_id_str 1329
network_name_str SEDICI (UNLP)
spelling Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015Tabesh, MaryamMagliano, D.J.Tanamas, S.K.Surmont, F.Bahendeka, S.Chiang, C. E.Elgart, Jorge FedericoGagliardino, Juan JoséKalra, SanjayKrishnamoorthy, S.Luk, AndreaMaegawa, H.Motala, A.A.Pirie, F.Ramachandran, A.Tayeb, K.Vikulova, O.Wong, J.Shaw, J.E.SaludMedicinaCiencias MédicasEnfermedad cardiovascularComplicaciones de la DiabetesNorth americaWestern europeEndocrinología<i>Aim</i>: 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. <i>Methods</i>: 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. <i>Data included</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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 Aplicada2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArticulohttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdf878-887http://sedici.unlp.edu.ar/handle/10915/96677enginfo:eu-repo/semantics/altIdentifier/url/https://ri.conicet.gov.ar/11336/94950info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/full/10.1111/dme.13858info:eu-repo/semantics/altIdentifier/issn/0742-3071info:eu-repo/semantics/altIdentifier/doi/10.1111/dme.13858info:eu-repo/semantics/altIdentifier/hdl/11336/94950info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc/4.0/Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)reponame:SEDICI (UNLP)instname:Universidad Nacional de La Platainstacron:UNLP2025-09-29T11:20:15Zoai:sedici.unlp.edu.ar:10915/96677Institucionalhttp://sedici.unlp.edu.ar/Universidad públicaNo correspondehttp://sedici.unlp.edu.ar/oai/snrdalira@sedici.unlp.edu.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:13292025-09-29 11:20:16.265SEDICI (UNLP) - Universidad Nacional de La Platafalse
dc.title.none.fl_str_mv Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
title Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
spellingShingle Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
Tabesh, Maryam
Salud
Medicina
Ciencias Médicas
Enfermedad cardiovascular
Complicaciones de la Diabetes
North america
Western europe
Endocrinología
title_short Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
title_full Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
title_fullStr Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
title_full_unstemmed Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
title_sort Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015
dc.creator.none.fl_str_mv Tabesh, Maryam
Magliano, D.J.
Tanamas, S.K.
Surmont, F.
Bahendeka, S.
Chiang, C. E.
Elgart, Jorge Federico
Gagliardino, Juan José
Kalra, Sanjay
Krishnamoorthy, S.
Luk, Andrea
Maegawa, H.
Motala, A.A.
Pirie, F.
Ramachandran, A.
Tayeb, K.
Vikulova, O.
Wong, J.
Shaw, J.E.
author Tabesh, Maryam
author_facet Tabesh, Maryam
Magliano, D.J.
Tanamas, S.K.
Surmont, F.
Bahendeka, S.
Chiang, C. E.
Elgart, Jorge Federico
Gagliardino, Juan José
Kalra, Sanjay
Krishnamoorthy, S.
Luk, Andrea
Maegawa, H.
Motala, A.A.
Pirie, F.
Ramachandran, A.
Tayeb, K.
Vikulova, O.
Wong, J.
Shaw, J.E.
author_role author
author2 Magliano, D.J.
Tanamas, S.K.
Surmont, F.
Bahendeka, S.
Chiang, C. E.
Elgart, Jorge Federico
Gagliardino, Juan José
Kalra, Sanjay
Krishnamoorthy, S.
Luk, Andrea
Maegawa, H.
Motala, A.A.
Pirie, F.
Ramachandran, A.
Tayeb, K.
Vikulova, O.
Wong, J.
Shaw, J.E.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Salud
Medicina
Ciencias Médicas
Enfermedad cardiovascular
Complicaciones de la Diabetes
North america
Western europe
Endocrinología
topic Salud
Medicina
Ciencias Médicas
Enfermedad cardiovascular
Complicaciones de la Diabetes
North america
Western europe
Endocrinología
dc.description.none.fl_txt_mv <i>Aim</i>: 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. <i>Methods</i>: 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. <i>Data included</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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
description <i>Aim</i>: 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. <i>Methods</i>: 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. <i>Data included</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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.
publishDate 2018
dc.date.none.fl_str_mv 2018
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info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.none.fl_str_mv http://sedici.unlp.edu.ar/handle/10915/96677
url http://sedici.unlp.edu.ar/handle/10915/96677
dc.language.none.fl_str_mv eng
language eng
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info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/full/10.1111/dme.13858
info:eu-repo/semantics/altIdentifier/issn/0742-3071
info:eu-repo/semantics/altIdentifier/doi/10.1111/dme.13858
info:eu-repo/semantics/altIdentifier/hdl/11336/94950
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