| Title | Primacy of the 3B Approach to Control Risk Factors for Cardiovascular Disease in Type 2 Diabetes Patients |
| Authors | Ji, Linong Hu, Dayi Pan, Changyu Weng, Jianping Huo, Yong Ma, Changsheng Mu, Yiming Hao, Chuanming Ji, Qiuhe Ran, Xingwu Su, Benli Zhuo, Hanjing Fox, Keith A. A. Weber, Michael Zhang, Danyi |
| Affiliation | Peking Univ, Peoples Hosp, Dept Endocrinol & Metab, Beijing 100044, Peoples R China. Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100044, Peoples R China. Beijing 301 Mil Gen Hosp, Dept Endocrinol, Beijing, Peoples R China. Sun Yat Sen Univ, Affiliated Hosp 3, Dept Endocrinol, Guangzhou 510275, Guangdong, Peoples R China. Peking Univ, Affiliated Hosp 1, Dept Cardiol, Beijing 100044, Peoples R China. Capital Med Univ, Beijing An Zhen Hosp, Dept Cardiol, Beijing, Peoples R China. Fudan Univ, Huashan Hosp, Dept Nephrol, Shanghai 200433, Peoples R China. Forth Mil Med Univ, Xi Jing Hosp, Dept Endocrinol, Xian, Peoples R China. Sichuan Univ, West China Hosp, Dept Endocrinol, Chengdu 610064, Peoples R China. Da Lian Med Univ, Affiliated Hosp, Dept Endocrinol, Dalian, Peoples R China. VitalStrateg Res Inst, Berwyn, PA USA. Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland. SUNY Downstate Coll Med, Dept Med, Brooklyn, NY USA. Peking Univ, Peoples Hosp, Dept Endocrinol & Metab, 11 Xi Zhi Men Nan Da Jie, Beijing 100044, Peoples R China. |
| Keywords | Cardiovascular risk factor China Dyslipidemia Hyperglycemia Hypertension Type 2 diabetes CORONARY-HEART-DISEASE MYOCARDIAL-INFARCTION GENERAL-PRACTICE BLOOD-PRESSURE POPULATION MELLITUS PREVALENCE CHINA GUIDELINES PROGNOSIS |
| Issue Date | 2013 |
| Citation | AMERICAN JOURNAL OF MEDICINE.2013,126,(10). |
| Abstract | BACKGROUND: Individually, diabetes mellitus, hypertension, and dyslipidemia have been shown to increase the risk of cardiovascular disease. While traditional management of Type 2 diabetes has focused mainly on glycemic control, robust evidence supports the integration of hypertension and dyslipidemia management to reduce the risk of cardiovascular disease. The primary objective of this study was to assess the level of control of blood glucose, blood pressure, and blood lipids (3Bs) among patients with type 2 diabetes. An additional objective was to investigate the impact of hospital type, physician specialty, treatment pattern, and patient profile on clinical outcomes. METHODS: This was a cross-sectional, multicenter observational study. A nationally representative sample of outpatients with established type 2 diabetes were enrolled at hospitals representative of geographic regions, tiers, and physician specialties in China. Main clinical measurements were the levels of glycosylated hemoglobin (HbA1c), blood pressure, and total serum cholesterol in reference to target goals. RESULTS: A total of 25,817 adults with type 2 diabetes (mean age 62.6 years, 47% male) were enrolled at 104 hospitals. Seventy-two percent reported comorbid hypertension, dyslipidemia, or both. Patients with concurrent type 2 diabetes, hypertension, and dyslipidemia were 6 times more likely to report a prior history of cardiovascular disease compared with those with type 2 diabetes alone. The mean HbA1c level was 7.6%. While 47.7%, 28.4%, and 36.1% of patients achieved the individual target goals for control of blood glucose (HbA1c <7%), blood pressure (systolic blood pressure <130 mm Hg, diastolic blood pressure <80 mm Hg), and blood lipids (total cholesterol <4.5 mmol/L), respectively, only 5.6% achieved all 3 target goals. Lower body mass index (<24 kg/m(2)), no active smoking or drinking, higher education, and diabetes duration <5 years were independent predictors of better cardiovascular disease risk control. CONCLUSION: Achieving adequate control of risk factors for cardiovascular disease in patients with type 2 diabetes remains a clinical challenge. Interventions to achieve control of 3Bs coupled with modification of additional cardiovascular disease predictors are crucial for optimization of clinical outcomes in patients with type 2 diabetes. (c) 2013 Elsevier Inc. All rights reserved. |
| URI | http://hdl.handle.net/20.500.11897/159301 |
| ISSN | 0002-9343 |
| DOI | 10.1016/j.amjmed.2013.02.035 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 人民医院 第一医院 |
