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Most adults with diabetes, CVD do not meet secondary prevention targets
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PHILADELPHIA — Less than one-third of adults with diabetes and cardiovascular disease achieve goals for secondary prevention, including smoking cessation, use of prophylactic medications, and blood pressure and lipid control, according to a speaker here.
Approximately 41% of adults with the two diseases in North America and about 25% of those in Europe and Latin America meet these targets, indicating that most patients are undertreated, Ann Marie Navar, MD, PhD, assistant professor of medicine at the Duke Clinical Research Institute, said during her presentation.
“Despite having multiple therapies to reduce the risk of stroke and heart attack in adults with diabetes and established cardiovascular disease, only about 1 in 3 adults globally in the TECOS trial were achieving all prevention targets,” Navar told Endocrine Today. “The biggest area for improvement globally is in blood pressure. Just over half of adults with diabetes and cardiovascular disease have their blood pressure controlled.”
Navar and Neha Pagidipati, MD, MPH, also an assistant professor of medicine at the Duke Clinical Research Institute, and colleagues evaluated baseline data from the Trial Evaluating Cardiovascular Outcomes with Sitagliptin, collected between 2008 and 2012, on 13,616 adults with diabetes and established CVD from 38 countries to assess attainment of CVD secondary prevention targets and associations between target attainment and CV endpoints, including CV mortality, myocardial infarction or stroke. The five prevention targets included use of aspirin and anti-hypertension medications, LDL cholesterol less than 70 mg/dL or statin use, BP less than 140 mm Hg systolic and less than 90 mm Hg diastolic, and non-smoking status.
Globally, less than one-third of this high-risk population met all five secondary prevention targets, according to Navar, whereas almost three-quarters met four of the targets. Almost 90% of participants reported non-smoking status, which was the target most often met, and 58% demonstrated BP control, the target met least often.
“There was also a lot of variability from country to country, so it appears where you live affects your likelihood of receiving optimal secondary prevention therapy,” Navar told Endocrine Today. – by Jill Rollet
Reference:
Navar AM. Secondary prevention of CVD in patients with T2DM: international insights from the TECOS trial. Presented at: Presented at: Heart in Diabetes Clinical Education Conference; July 13-15, 2018; Philadelphia.
Pagidipati NJ, et al. Circulation. 2017;doi:10.1161/circulationaha.117.027252
Disclosures: Navar reports no relevant financial disclosures. The study was funded by Merck & Co. Please see the study for all other authors’ relevant financial disclosures.