Guidelines just published online in the Journal of Clinical Endocrinology & Metabolism have stressed once again that blood pressure, waist circumference, fasting lipid profile, and blood glucose should be measured regularly to identify atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes mellitus (T2DM).
James L. Rosenzweig, M.D., from the Hebrew Rehabilitation Hospital in Boston, and colleagues developed clinical practice guidelines for primary prevention of ASCVD and T2DM in patients at metabolic risk for developing these conditions.
The researchers note that health care providers should incorporate regular screening and identification of individuals at metabolic risk. Screening should include measuring blood pressure, waist circumference, fasting lipid profile, and blood glucose.
Ten-year global risk assessment for ASCVD or coronary heart disease should be performed for individuals identified at metabolic risk to determine targets of therapy for reduction of apolipoprotein B-containing lipoproteins. Lifestyle management should be the first priority for primary prevention of ASCVD and T2DM.
A heart-healthy dietary pattern and sodium restriction should be included, together with an active lifestyle incorporating daily walking, limited sedentary time, and a structured physical activity program. Loss of ≥5 percent of initial body weight should be the goal for the first year in individuals with excess weight.
“We emphasize the importance of lifestyle, dietary, and behavioural changes as the first-line treatment,” Rosenzweig said in a statement. “However, treatment with medication is appropriate if goals are not met with lifestyle changes alone.”
REFERENCE: Rozenzweig et al: Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline; https://academic.oup.com/jcem/article/104/9/3939/5540926