Pustaka Ilmiah Universitas Padjadjaran

Abstrak

The Prevention of Cardiovascular Events in Patients with Type 2 Diabetes

Diabetes Mellitus is one of the greatest threats to the health of population worldwide. Globally, there are approximately 250 millions people with diabetes and that number is estimated to rise to 380 mdlions in 2025. Patients with type 2 Diabetes have a greater incidence of cardiovascular disease cerebrovascular disease and renal disease than the general population. Cardiovascular disease is responsible for deaths in person with type 2 diabetes. Opportunities to modify riks for coronary events, strokes and other patient-oriented clinical outcomes often are missed. In patients with type 2 diabetes, the risk of diabetic macrovascular and microvascular complications were strongly associated with previous hyperglycemia and raised blood pressure. improving blood glucose level and lewering blood pressure can reduce the frequency of compliostions such as blindness, amputation, end – stage renal disease. coronary events and cardiovascular death. ADVANCE treatment strategy has potential to save, lives and protect diabetes from serious complication. The major finding of ADVANCE show. that Intensive blood glucose lowering treatment: 1) safely controlled blood glucose to a mean HbA1C level of 6,5% 2) Significantly reduced the overall risk. of serious diabetes complications ( by 10%), a one fifth (2 1%) reduction in kidney disease and the development of proteinuria a well established marker of increased cardiovascular risk, 3) achieved a positive trend towards reduction in the risk of crdiovascular death (12%) although not statistically significant. ADVANCE showed that perindopril/indapamide combinations, significantly reduces total mortality by 14% the risk on cardiovascular death by 18% a significant 14% reduction in total coronary events and a 21% reduction in renal events. However, a proactive management plan should include patient – centered goal not only for controlling glycemia and hypertension. Lipid lowering therapy should be considered in patients with diabetes and dislipidemia, particularly in those with coronary artery disease. Lifestyle changes (diet, exercise, smoking cessation) and daily aspirin also are important variables that contribute to risk reduction.