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Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association
Open accessAbstract
Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus.
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“As such, while all patients with T2DM and CAD certainly benefit from a blood pressure of <140/90 mm Hg,5,63–66,76”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [63]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“For people who already have diabetes, lifestyle modification and pharmacological treatment, as well as blood pressure and cholesterol control, can delay progression to complications and reduce mortality, or even help with remission, especially if started early.1,2,58–62”
From Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants (2024) · cites this paper as [59]
Experimental — accuracy not yet measuredIn the citing paper
“Epidemiological studies have shown that high levels of LDL-C and non-HDL-C and low levels of HDL-C are associated with an increased risk of CV events and mortality in patients with and without diabetes.246”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [246]
In the citing paper
“The most common causes of death in patients with T2DM and CKD are atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) (6,7).”
From SGLT2 inhibition for CKD and cardiovascular disease in type 2 diabetes: report of a scientific workshop sponsored by the National Kidney Foundation (2021) · cites this paper as [7]
In the citing paper
“The presence of hypertension in patients with T2DM significantly increases the risk of myocardial infarction, stroke, and all-cause mortality.63,64”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [63]
In the citing paper
“The prevalence of hypertension in patients with T2DM is ≈2-fold greater than in the general population, with the vast majority of patients with T2DM (70%–80%) having concomitant hypertension.63”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [63]
In the citing paper
“Early interventional randomized trials showed benefit of aggressive blood pressure reduction in reducing the increased risk of both macrovascular and microvascular events in patients with T2DM.63”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [63]
In the citing paper
“Epidemiological observations have demonstrated that there is a progressive increase in the risk of macrovascular and microvascular events with increasing levels of systolic blood pressure starting at 115 mm Hg.63–65”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [63]
In the citing paper
“Instead, evidence to support lifestyle and health behavior management for T2DM and stable CAD has been extrapolated from primary prevention trials and from subgroups of participants with T2DM from studies focusing on the secondary prevention of CAD.63,136”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [63]
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Metadata
- Authors
- Fox, C. S., Golden, S. H., Anderson, C., Bray, G. A., Burke, L. E., de Boer, I. H., Deedwania, P., Eckel, R. H., Ershow, A. G., Fradkin, J., Inzucchi, S. E., Kosiborod, M., Nelson, R. G., Patel, M. J., Pignone, M., Quinn, L., Schauer, P. R., Selvin, E., & Vafiadis, D. K.
- Affiliations
- National Heart, Lung, and Blood Institute (US)
- Johns Hopkins University (US)
- University of California San Diego (US)
- Pennington Biomedical Research Center (US)
- University of Pittsburgh (US)
- University of California, San Francisco (US)
- Office of Dietary Supplements (US)
- National Institutes of Health (US)
- Yale University (US)
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- University of Illinois Chicago (US)
- Cleveland Clinic (US)
- American Heart Association (US)
- ORCID
- Venue
- Circulation
- Published
- 2015-08-25
- Volume
- 132
- Issue
- 8
- Pages
- 691-718
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC9728095
- OpenAlex
- W2172043580
- Cited by
- 386
- References
- 262
- Citations by year
- 2026: 16 · 2025: 8 · 2024: 18 · 2023: 18 · 2022: 35 · 2021: 40 · 2020: 45 · 2019: 41 · 2018: 55 · 2017: 61 · 2016: 42 · 2015: 7
- FWCI
- 47.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (ZIADK069062, P30DK079637)
- 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 › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- type 2 diabetes, cardiovascular disease prevention, primary prevention, blood pressure control, glycemic control, cholesterol management, aspirin therapy, lifestyle modification, kidney disease screening, subclinical cardiovascular disease, clinical guidelines
- MeSH terms
- American Heart Association, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Primary Prevention, Risk Factors, United States, Randomized Controlled Trials as Topic, Practice Guidelines as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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