Primary prevention of ASCVD and T2D: new Endocrine Society guidelines

  • Rosenzweig JL & al.
  • J Clin Endocrinol Metab
  • 31.07.2019

  • von Miriam Tucker
  • Clinical Essentials
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Takeaway

  • New Endocrine Society clinical practice guidelines address primary prevention of atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes (T2D) in individuals at risk.
  • Cosponsored by the American Diabetes Association and the European Society of Endocrinology.

Key recommendations

  • Regularly screen and identify individuals age 40-75 years at metabolic risk for ASCVD and T2D by measuring BP, waist circumference, fasting lipid profile, and blood glucose.
  • In those at risk, apply a 10-year global risk assessment for ASCVD or coronary heart disease to determine therapy targets for reducing apolipoprotein B-containing lipoproteins.
  • Hypertension should be treated to guideline targets.
  • Individuals identified with prediabetes should be tested at least annually for progression to T2D and referred to intensive behavioral counseling programs.
  • Lifestyle management should be the first priority for primary prevention of ASCVD and T2D.
  • Behavioral programs should include heart-healthy dietary pattern, sodium restriction, daily walking, limited sedentary time, and structured physical activity program.
  • Those with overweight/obesity should aim for ≥5% reduction in initial body weight in the first year.
  • Behavior changes should be supported by a comprehensive program led by trained interventionists and reinforced by clinicians.
  • Pharmacological therapy can be added to lifestyle modification if recommended goals are not achieved.