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2009 SIPREC Consensus Document — Executive Summary

Cardiovascular Prevention in Subjects with Impaired Fasting Glucose or Impaired Glucose Tolerance

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Abstract

Cardiovascular diseases still represent the leading cause of mortality and hospitalization, worldwide. As a consequence of the marked demographic changes observed in the general population, the improved survival rate after an acute cardiovascular event and the progressive rise of costs (mostly due to technological and pharmacological innovations), the estimated burden of cardiovascular diseases will be soon become insurmountable for national healthcare systems. In this view, an integrated approach aimed at improving strategies for cardiovascular disease prevention and, thus, limiting the negative outcomes, would probably be successful. Such an approach may not only achieve long-term benefits, but even significant advantages in the short to medium term, mostly in asymptomatic high-risk individuals. Indeed, this latter population of asymptomatic high-risk individuals would mostly benefit from extensive application and improvement of strategies for cardiovascular disease prevention with a favourable cost-benefit ratio.

The Italian Society for Cardiovascular Disease Prevention — Società Italiana per la Prevenzione Cardiovascolare (SIPREC) — has recognized this strategic aim, focusing a significant part of its institutional actions on the effort for providing educational supports and consensus documents, which represent an overview of the scientific knowledge and personal clinical expertise by national and international key opinion leaders. Expert committees periodically generate ‘state-of-the-art’ documents on specific scientific topics with relevant socioeconomic implications and large clinical impact. The present article is dedicated to healthcare professionals, is based on the available evidence, and provides information on diagnostic algorithms and therapeutic options on abnormal glucose regulation (or dysglycaemia).

The relationship between abnormalities in glucose metabolism and cardiovascular complications represents an important and relatively early target for cardiovascular disease prevention. SIPREC identified, even in this clinical setting, a group of scientific experts in order to form a multidisciplinary ‘task force’. This group has been asked to explain in a short, simple and effective fashion the epidemiological impact and the pathophysiological nature of the problem, its clinical features, potential diagnostic algorithms and therapeutic options, and its influence on the clinical practice of both specialist physicians and general practitioners.

This work provides the background for discussing novel future strategies for cardiovascular prevention. It is also aimed at highlighting the importance of an emerging marker of cardiovascular risk, which is often not recognized and underestimated.

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References

  1. Volpe M, Borghi C, Cavallo P, et al., on behalf of the SIPREC Working Group. Cardiovascular prevention in subjects with impaired fasting glucose or impaired glucose tolerance. High Blood Press Cardiovasc Prev 2010; 17(2): 73–102

    Article  Google Scholar 

  2. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group. Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. BMJ 1998 Aug 8; 317 (7155): 371–5

  3. Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care 2006 May; 29(5): 1130–9

    Article  PubMed  CAS  Google Scholar 

  4. Gerstein HC, Santaguida P, Raina P, et al. Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res Clin Pract 2007 Dec; 78(3): 305–12

    Article  PubMed  Google Scholar 

  5. Danaei G, Lawes CM, Vander Hoorn S, et al. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment. Lancet 2006 Nov 11; 368(9548): 1651–9

    Article  PubMed  Google Scholar 

  6. Bartnik M, Norhammar A, Ryden L. Hyperglycaemia and cardiovascular disease. J Intern Med 2007 Aug; 262(2): 145–56

    Article  PubMed  CAS  Google Scholar 

  7. Bianchi C, Miccoli R, Penno G, et al. Primary prevention of cardiovascular disease in people with dysglycemia. Diabetes Care 2008 Feb; 31Suppl. 2: S208–14

    Article  PubMed  Google Scholar 

  8. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med 2006 Feb 2; 354(5): 449–61

    Article  PubMed  Google Scholar 

  9. Suleiman M, Hammerman H, Boulos M, et al. Fasting glucose is an important independent risk factor for 30-day mortality in patients with acute myocardial infarction: a prospective study. Circulation 2005 Feb 15; 111(6): 754–60

    Article  PubMed  CAS  Google Scholar 

  10. Buse JB, Ginsberg HN, Bakris GL, et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2007 Jan 2; 115(1): 114–26

    Article  PubMed  Google Scholar 

  11. Deedwania P, Kosiborod M, Barrett E, et al. Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2008 Mar 25; 117(12): 1610–9

    Article  PubMed  Google Scholar 

  12. Lloyd-Jones DM, Wilson PW, Larson MG, et al. Framingham risk score and prediction of lifetime risk for coronary heart disease. Am J Cardiol 2004 Jul 1; 94(1): 20–4

    Article  PubMed  Google Scholar 

  13. Conroy RM, Pyorala K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003 Jun; 24(11): 987–1003

    Article  PubMed  CAS  Google Scholar 

  14. Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 2006 Mar 21; 113(11): e463–654

    Article  PubMed  Google Scholar 

  15. Mancia G, De Backer G, Dominiczak A, et al. 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension. J Hypertens 2007 Sep; 25(9): 1751–62

    Article  PubMed  CAS  Google Scholar 

  16. American Diabetes Association. Consensus development conference on the diagnosis of coronary heart disease in people with diabetes: 10–11 February 1998, Miami, Florida. Diabetes Care 1998 Sep; 21 (9): 1551–9

    Google Scholar 

  17. Scholte AJ, Schuijf JD, Kharagjitsingh AV, et al. Prevalence of coronary artery disease and plaque morphology assessed by multi-slice computed tomography coronary angiography and calcium scoring in asymptomatic patients with type 2 diabetes. Heart 2008 Mar; 94(3): 290–5

    Article  PubMed  CAS  Google Scholar 

  18. Shaw LJ, Berman DS, Blumenthal RS, et al. Clinical imaging for prevention: directed strategies for improved detection of presymptomatic patients with undetected atherosclerosis, part I: clinical imaging for prevention. J Nucl Cardiol 2008 Jan-Feb; 15(1): e6–19

    Article  PubMed  Google Scholar 

  19. Harris R, Donahue K, Rathore SS, et al. Screening adults for type 2 diabetes: a review of the evidence for the US Preventive Services Task Force. Ann Intern Med 2003 Feb 4; 138(3): 215–29

    PubMed  Google Scholar 

  20. Poli A, Marangoni F, Paoletti R, et al. Non-pharmacological control of plasma cholesterol levels. Nutr Metab Cardiovasc Dis 2008 Feb; 18(2): S1–16

    Article  PubMed  CAS  Google Scholar 

  21. Riccardi G, Rivellese AA, Giacco R. Role of glycemic index and glycemic load in the healthy state, in prediabetes, and in diabetes. Am J Clin Nutr 2008 Jan; 87(1): 269S–74S

    PubMed  CAS  Google Scholar 

  22. Mann JI, De Leeuw I, Hermansen K, et al. Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus. Nutr Metab Cardiovasc Dis 2004 Dec; 14(6): 373–94

    Article  PubMed  CAS  Google Scholar 

  23. Eriksson KF, Lindgarde F. Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise: the 6-year Malmo feasibility study. Diabetologia 1991 Dec; 34(12): 891–8

    Article  PubMed  CAS  Google Scholar 

  24. Knowler WC, Sartor G, Melander A, et al. Glucose tolerance and mortality, including a substudy oftolbutamide treatment. Diabetologia 1997 Jun; 40(6): 680–6

    Article  PubMed  CAS  Google Scholar 

  25. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002 Feb 7; 346(6): 393–403

    Article  PubMed  CAS  Google Scholar 

  26. Chiasson JL, Josse RG, Gomis R, et al. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 2002 Jun 15; 359(9323): 2072–7

    Article  PubMed  CAS  Google Scholar 

  27. Bosch J, Yusuf S, Gerstein HC, et al. Effect of ramipril on the incidence of diabetes. N Engl J Med 2006 Oct 12; 355(15): 1551–62

    Article  PubMed  Google Scholar 

  28. McMurray JJ, Holman RR, Haffner SM, et al. Effect of valsartan on the incidence of diabetes and cardiovascular events. N Engl J Med 2010 Apr 22; 362(16): 1477–90

    Article  PubMed  CAS  Google Scholar 

  29. Holman RR, Haffner SM, McMurray JJ, et al. Effect of nateglinide on the incidence of diabetes and cardiovascular events. N Engl J Med 2010 Apr 22; 362(16): 1463–76

    Article  PubMed  CAS  Google Scholar 

  30. Kearney PM, Blackwell L, Collins R, et al. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008 Jan 12; 371(9607): 117–25

    Article  PubMed  CAS  Google Scholar 

  31. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005 Oct 8; 366(9493): 1267–78

    Article  PubMed  CAS  Google Scholar 

  32. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005 Oct 25; 112(17): 2735–52

    Article  PubMed  Google Scholar 

  33. Graham DJ, Staffa JA, Shatin D, et al. Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs. JAMA 2004 Dec 1; 292(21): 2585–90

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The present article was endorsed by the Italian Society of Cardiovascular Prevention (SIPREC). This work has been partially supported by an unconditioned educational grant by Sanofi-Aventis, Italy.

Reviewers of the article: Maurizio Averna, Paolo Bellotti, Graziella Bruno, Emilio Chiurlia, Francesco Cosentino, Gaetano Crepaldi, Cristina Giannattasio, Giulio Nati, Mario Petretta, Paolo Pintus and Bianca Rocca.

Writing Group of the English version of the article: Diana Chin, Marta Di Vavo, Alessandra Frattari and Giuliano Tocci.

Professor Chiariello died on 23 March 2010.

Author information

Authors and Affiliations

  1. Division of Cardiology, II Faculty of Medicine, University “La Sapienza”, Sant’Andrea Hospital, Via di Grottarossa 1035-9, 00189, Rome, Italy

    Massimo Volpe (Chair)

  2. IRCCS Neuromed, Pozzilli, Isernia, Italy

    Massimo Volpe (Chair)

  3. Department of Internal Medicine, University of Bologna, Bologna, Italy

    Claudio Borghi

  4. Department of Internal Medicine, University of Turin, Turin, Italy

    Paolo Cavallo Perin

  5. Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Naples, Italy

    Massimo Chiariello & Bruno Trimarco

  6. Department of Medical and Surgical Sciences, University of Padua, Padua, Italy

    Enzo Manzato

  7. Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy

    Roberto Miccoli

  8. Department of Cardiology, University Hospital of Modena, Modena, Italy

    Maria G. Modena

  9. Division of Endocrinology and Metabolic Disease, University of Naples “Federico II”, Naples, Italy

    Gabriele Riccardi

  10. Department of Clinical and Experimental Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy

    Giorgio Sesti

  11. Division of Metabolic Diseases, Department of Clinical Medicine, University of Padova, Padova, Italy

    Antonio Tiengo

  12. Centro di Prevenzione Cardiovascolare, ASS4, Udine, Italy

    Diego Vanuzzo

  13. Division of Cardiology, “Preventive Cardiology” Research Unit, S. Maria della Misericordia Hospital, Perugia, Italy

    Paolo Verdecchia

  14. University of Florence, Florence, Italy

    Augusto Zaninelli

  15. Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Diseases, Ospedale Cisanello, Pisa, Italy

    Stefano Del Prato

Authors
  1. Massimo Volpe
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  2. Claudio Borghi
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  3. Paolo Cavallo Perin
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  15. Stefano Del Prato
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Corresponding author

Correspondence to Massimo Volpe.

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Volpe, M., Borghi, C., Perin, P.C. et al. 2009 SIPREC Consensus Document — Executive Summary. High Blood Press Cardiovasc Prev 17, 237–247 (2010). https://doi.org/10.2165/11311990-000000000-00000

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  • DOI: https://doi.org/10.2165/11311990-000000000-00000

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