ADA/AHA Stress Joint Commitment to Prevent Diabetes and CV Disease
ADA/AHA Stress Joint Commitment to Prevent Diabetes and CV Disease
" simply ascertaining... blood glucose and low-density lipoprotein-cholesterol levels, blood pressure, and tobacco use, as well as noting the presence of obesity, may be sufficient to initiate the appropriate interventions to prevent or identify diabetes and emerging cardiovascular disease."
The American Diabetes Association (ADA) and the American Heart Association (AHA), which lately have seemed as though they might be at odds in their approach to cardiovascular risk factor management, "remain unified and committed to reducing the burden of diabetes and cardiovascular disease," according to a joint statement issued by the 2 organizations. The statement, published simultaneously in Circulation and Diabetes Care, calls for renewed effort by healthcare providers to prevent both conditions by identifying and treating a core set of risk factors such as prediabetes, hypertension, dyslipidemia, and obesity. The importance of this "cannot be overstated," according to Robert H. Eckel, MD (University of Colorado Health Sciences Center, Denver), AHA President and lead author of the statement. "It is long past time to start getting these risk factors under control through lifestyle changes and medication," he said. "It's not as if we don't know how. The research is there."
The ADA/AHA statement focuses on the link between diabetes and cardiovascular disease, stressing that adults with diabetes are at a 2- to 4-fold higher risk compared with nondiabetic adults. The statement urges wider adoption of risk assessment algorithms, such as the ADA's Diabetes PHD (Personal Health Decisions; www.diabetes.org/diabetesphd), which is currently the only tool that has been widely validated, the statement says. Diabetes PHF is an interactive, Web-based technology that enables users to create a health risk profile based on personal health parameters such as age, sex, height, weight, health history, and medications. It can be used to predict risk of developing cardiovascular disease/diabetes or to determine possible effects of treatment after development of diabetes/cardiovascular disease, the statement notes. It also points out that doing no more than simply ascertaining a person's blood glucose and low-density lipoprotein cholesterol levels, blood pressure, and tobacco use, as well as noting the presence of obesity, "may be sufficient to initiate the appropriate interventions to prevent or identify diabetes and emerging cardiovascular disease."
The ADA/AHA statement also addresses the concept of the "metabolic syndrome," which the associations have defined somewhat differently in the past. In 2005, a joint statement from the ADA and its European equivalent (the European Association for the Study of Diabetes) said that although the term was "a useful paradigm," it had "taken on a greater meaning and import than justified by current knowledge." The statement recommended that "patients with diabetes or clinical cardiovascular disease should be excluded from the case definition of metabolic syndrome." Later the same year, the AHA issued a statement recognizing the metabolic syndrome as a complex disorder and recommending that the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III diagnostic criteria for clinical diagnosis of the metabolic syndrome be maintained, with minor modifications. The 2 associations blame "some of the medical press," including JAMA, the journal of the American Medical Association, for interpreting discussion of the metabolic syndrome as a "battle" about the scientific issues related to the syndrome. They say that by appearing to question risk factor identification and treatment, the "presumed dispute" could adversely affect "the favorable trend in many aspects of cardiovascular risk factor reduction."
While acknowledging that opinions, including those of medical organizations, differ as to the clinical usefulness of the metabolic syndrome, the statement emphasized the common goals of the ADA and the AHA. Statement coauthor Robert A. Rizza, MD (Mayo Clinic College of Medicine, Rochester, Minnesota), ADA President, Medicine and Science, said that "the 2 associations are in 100% agreement that more can be done by professionals and patients alike to better understand, anticipate, prevent and manage the commonalities and co-occurrence of diabetes and cardiovascular disease."
References
" simply ascertaining... blood glucose and low-density lipoprotein-cholesterol levels, blood pressure, and tobacco use, as well as noting the presence of obesity, may be sufficient to initiate the appropriate interventions to prevent or identify diabetes and emerging cardiovascular disease."
The American Diabetes Association (ADA) and the American Heart Association (AHA), which lately have seemed as though they might be at odds in their approach to cardiovascular risk factor management, "remain unified and committed to reducing the burden of diabetes and cardiovascular disease," according to a joint statement issued by the 2 organizations. The statement, published simultaneously in Circulation and Diabetes Care, calls for renewed effort by healthcare providers to prevent both conditions by identifying and treating a core set of risk factors such as prediabetes, hypertension, dyslipidemia, and obesity. The importance of this "cannot be overstated," according to Robert H. Eckel, MD (University of Colorado Health Sciences Center, Denver), AHA President and lead author of the statement. "It is long past time to start getting these risk factors under control through lifestyle changes and medication," he said. "It's not as if we don't know how. The research is there."
The ADA/AHA statement focuses on the link between diabetes and cardiovascular disease, stressing that adults with diabetes are at a 2- to 4-fold higher risk compared with nondiabetic adults. The statement urges wider adoption of risk assessment algorithms, such as the ADA's Diabetes PHD (Personal Health Decisions; www.diabetes.org/diabetesphd), which is currently the only tool that has been widely validated, the statement says. Diabetes PHF is an interactive, Web-based technology that enables users to create a health risk profile based on personal health parameters such as age, sex, height, weight, health history, and medications. It can be used to predict risk of developing cardiovascular disease/diabetes or to determine possible effects of treatment after development of diabetes/cardiovascular disease, the statement notes. It also points out that doing no more than simply ascertaining a person's blood glucose and low-density lipoprotein cholesterol levels, blood pressure, and tobacco use, as well as noting the presence of obesity, "may be sufficient to initiate the appropriate interventions to prevent or identify diabetes and emerging cardiovascular disease."
The ADA/AHA statement also addresses the concept of the "metabolic syndrome," which the associations have defined somewhat differently in the past. In 2005, a joint statement from the ADA and its European equivalent (the European Association for the Study of Diabetes) said that although the term was "a useful paradigm," it had "taken on a greater meaning and import than justified by current knowledge." The statement recommended that "patients with diabetes or clinical cardiovascular disease should be excluded from the case definition of metabolic syndrome." Later the same year, the AHA issued a statement recognizing the metabolic syndrome as a complex disorder and recommending that the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III diagnostic criteria for clinical diagnosis of the metabolic syndrome be maintained, with minor modifications. The 2 associations blame "some of the medical press," including JAMA, the journal of the American Medical Association, for interpreting discussion of the metabolic syndrome as a "battle" about the scientific issues related to the syndrome. They say that by appearing to question risk factor identification and treatment, the "presumed dispute" could adversely affect "the favorable trend in many aspects of cardiovascular risk factor reduction."
While acknowledging that opinions, including those of medical organizations, differ as to the clinical usefulness of the metabolic syndrome, the statement emphasized the common goals of the ADA and the AHA. Statement coauthor Robert A. Rizza, MD (Mayo Clinic College of Medicine, Rochester, Minnesota), ADA President, Medicine and Science, said that "the 2 associations are in 100% agreement that more can be done by professionals and patients alike to better understand, anticipate, prevent and manage the commonalities and co-occurrence of diabetes and cardiovascular disease."
References
Eckel RH, Kahn R, Robertson RM, Rizza RA. Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. Circulation. 2006;113:2943-2946; Diabetes Care. 2006;29:1697-1699. Abstract
Kahn R, Buse J, Ferrannini E, Stern M. The Metabolic Syndrome: Time for a Critical Appraisal: Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2005:28:2289-2304. Abstract
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: Executive Summary. Circulation. 2005;112:2735-2752. Abstract