Macrovascular Complications

Prim Care. 2022 Jun;49(2):255-273. doi: 10.1016/j.pop.2021.11.012. Epub 2022 Apr 26.

Abstract

Because macrovascular complications of diabetes are the leading cause of mortality and decreased quality of life for individuals with diabetes, prevention and risk reduction are paramount. Besides lifestyle management, contemporary therapies can significantly reduce risk for cardiovascular events in diabetes. For primary prevention, most individuals should be on statin therapy, whereas those at high atherosclerotic cardiovascular disease risk should also be on glucagon-like peptide 1 receptor agonists (GLP1RA) or sodium/glucose cotransporter-2 inhibitors (SGLT2i) at any hemoglobin A1c. For secondary prevention, addition of GLP1RA or SGLT2i, PCKS9i, rivaroxaban, and/or icosapent ethyl should be considered in addition to a statin and low-dose aspirin.

Keywords: Atherosclerotic cardiovascular disease; Cardiovascular outcome trial; Diabetes; Heart failure; Risk factor modification.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases* / drug therapy
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucagon-Like Peptide-1 Receptor / agonists
  • Glucagon-Like Peptide-1 Receptor / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Hypoglycemic Agents / therapeutic use
  • Quality of Life
  • Sodium-Glucose Transporter 2 Inhibitors* / pharmacology
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use

Substances

  • Glucagon-Like Peptide-1 Receptor
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors