Cited by 104Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and ManagementBlood Pressure and Hypertension Studies

Legacy benefits of blood glucose, blood pressure and lipid control in individuals with diabetes and cardiovascular disease: Time to overcome multifactorial therapeutic inertia?

Khunti, Kamlesh, Kosiborod, Mikhail, Ray, Kausik K.·2018·Diabetes, Obesity and Metabolism

Abstract

Cardiovascular disease is a major cause of morbidity and mortality globally and the largest contributor to healthcare costs. There is good evidence that management of risk factors such as blood pressure, dyslipidaemia and glucose can lead to improved microvascular and macrovascular complications in individuals with type 2 diabetes mellitus. Legacy effect is a phenomenon used to describe the prolonged benefits of glucose, blood pressure or lipid control in individuals with cardiovascular disease, diabetes or in primary prevention of cardiovascular disease by early risk factor control. There is now also good quality evidence on the legacy benefits of multifactorial risk factor interventions on renal, cardiovascular and mortality outcomes. Despite this robust evidence, therapeutic inertia is widespread in the management of these risk factors in clinical practice.

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Crossref · 10.1111/dom.13243

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  • Addressing multiple cardiovascular risk factors (glycemic, blood pressure, and lipid management) simultaneously produces large benefits, with evidence for long-lasting benefits.

    “Furthermore, large benefits are seen when multiple cardiovascular risk factors (glycemic, blood pressure, and lipid management) are addressed simultaneously, with evidence for long-lasting benefits (3)(4)(5).”
  • Large benefits are seen when multiple cardiovascular risk factors (glycemic, blood pressure, and lipid management) are addressed simultaneously, with evidence for long-lasting benefits.

    “large benefits are seen when multiple cardiovascular risk factors (glycemic, blood pressure, and lipid management) are addressed simultaneously, with evidence for long-lasting benefits (3–5).”
  • Managing individual cardiovascular risk factors prevents or slows ASCVD in people with diabetes.

    “Numerous studies have shown the efficacy of managing individual cardiovascular risk factors in preventing or slowing ASCVD in people with diabetes.”

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Authors
Khunti, K., Kosiborod, M., & Ray, K. K.
Affiliations
  • University of Leicester (GB)
  • Saint Luke's Hospital (US)
  • Imperial College London (GB)
Corresponding author
Khunti, Kamlesh
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2018-03-11
Volume
20
Issue
6
Pages
1337-1341
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
OpenAlex
W2794361474
Cited by
104
References
30
Citations by year
2026: 12 · 2025: 15 · 2024: 15 · 2023: 12 · 2022: 10 · 2021: 9 · 2020: 13 · 2019: 15 · 2018: 3
FWCI
1.54
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care - East Midlands (NIHR CLAHRC - EM)
  • NIHR Leicester, Biomedical Research Centre
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
legacy effects, therapeutic inertia, type 2 diabetes, cardiovascular disease, glycemic control, blood pressure control, lipid control, microvascular complications, macrovascular complications, renal outcomes, mortality, cardiovascular risk factors
MeSH terms
Cardiovascular Diseases, Combined Modality Therapy, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Humans, Hyperglycemia, Hypertension, Hypoglycemia, Practice Patterns, Physicians', Risk Factors, Practice Guidelines as Topic, Evidence-Based Medicine, Dyslipidemias, Diabetic Cardiomyopathies

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