10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2022

American Diabetes Association Professional Practice Committee

doi:10.2337/dc22-s010

Cited by 869Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2022

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American Diabetes Association Professional Practice Committee·2022·Diabetes Care

DOI 10.2337/dc22-s010

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Abstract

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

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Recent data have increased confidence in the safety of the SGLT2i drug class.
“Recent data have increased con fi dence in the safety of the SGLT2i drug class (141,142).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
The SGLT2 Inhibitor Trials section (page unavailable) reports that the CREDENCE trial found no significant increase in several adverse events with canagliflozin, providing some basis for greater confidence in its safety. But it also reports increased diabetic ketoacidosis, and the cited safety findings concern canagliflozin in one trial rather than the SGLT2 inhibitor class as a whole. (LLM, conf=0.82)
Experimental — accuracy not yet measured
SGLT2i reduce plasma glucose by enhancing urinary excretion of glucose.
“The SGLT2i are oral medications that reduce plasma glucose by enhancing urinary excretion of glucose.”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
The Results of the Dapagliflozin and Prevention of Adverse section (page unavailable) says that sotagliflozin, a dual SGLT1/SGLT2 inhibitor, lowers glucose partly by increasing urinary glucose excretion. The passage supports the mechanism for that drug, but does not explicitly establish it for SGLT2 inhibitors as a class or state that they are oral medications. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Cardiorenal outcome trials demonstrated that SGLT2i reduce the risk of composite major adverse cardiovascular events, cardiovascular death, myocardial infarction, hospitalization for heart failure, and all-cause mortality and improve renal outcomes in individuals with type 2 diabetes with established or high risk of cardiovascular disease.
“Cardiorenal outcome trials have demonstrated their ef fi cacy in reducing the risk of composite major adverse cardiovascular events (MACE), cardiovascular death, myocardial infarction, hospitalization for heart failure (HHF), and all-cause mortality and improving renal outcomes in individuals with type 2 diabetes with an established/high risk of CVD.”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Cardiovascular outcome trials have demonstrated cardiovascular safety without cardiovascular risk reduction of four DPP-4i (saxagliptin, alogliptin, sitagliptin, and linagliptin).
“CVOTs have demonstrated the cardiovascular safety without cardiovascular risk reduction of four DPP-4i (saxagliptin, alogliptin, sitagliptin, and linagliptin) (141).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
The Glucose-Lowering Therapies and Cardiovascular Outcomes section says DPP-4 inhibitor trials have not shown cardiovascular benefit relative to placebo. But the Glucose-Lowering Therapies and Heart Failure section reports more heart-failure hospitalizations with saxagliptin than placebo (3.5% vs. 2.8%), so the unqualified claim of cardiovascular safety for all four drugs overstates the source. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
DPP-4i have more modest glucose-lowering efficacy and a neutral effect on weight and are well tolerated with minimal risk of hypoglycemia.
“They have a more modest glucose-lowering ef fi cacy and a neutral effect on weight and are well tolerated with minimal risk of hypoglycemia.”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
The Glucose-Lowering Therapies and Cardiovascular Outcomes section (page unavailable) reports lower rates of hypoglycemia with linagliptin than with glimepiride, supporting only the hypoglycemia portion for one DPP-4 inhibitor and comparator. The passages found do not address modest glucose-lowering efficacy, weight neutrality, or general tolerability, and they do not establish minimal hypoglycemia risk for the class. (LLM, conf=0.83)
Experimental — accuracy not yet measured

For patients with diabetes, hypertension, and low cardiovascular risk (defined as those with 10-year ASCVD risk <15%), the ADA recommends a BP target of <140/90 mmHg (grade A recommendation).
“For patients with diabetes, hypertension, and low cardiovascular risk (defined as those with 10-year ASCVD risk <15%), the ADA recommends a BP target of <140/90 mmHg (grade A recommendation) (40).”
From Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (2022) · cites this paper as [40]
SGLT2i use is associated with increased risk for mycotic genital infections, which are typically mild and treatable.
“Their use is associated with increased risk for mycotic genital infections, which are reported to be typically mild and treatable.”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
The SGLT2 Inhibitor Trials section discusses other safety outcomes, including diabetic ketoacidosis, but does not address genital infections. Searches for mycotic and genital infections, fungal or yeast infections, and whether infections are mild and treatable found no passage supporting the claim. Page numbers were unavailable in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measured
SGLT2i have intermediate-to-high glycemic efficacy, with lower glycemic efficacy at lower estimated glomerular filtration rate.
“They have intermediate-to-high glycemic ef fi cacy, with lower glycemic ef fi cacy at lower estimated glomerular fi ltration rate (eGFR).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
The Glucose-Lowering Therapies and Cardiovascular Outcomes section identifies SGLT2 inhibitors as diabetes therapies, but the passages from our copy focus on cardiovascular and kidney outcomes. Searches for glycemic efficacy and reduced glucose-lowering effect at lower eGFR found no passage stating either the intermediate-to-high efficacy rating or the claimed eGFR relationship. (LLM, conf=0.74)
Experimental — accuracy not yet measured
DPP-4i inhibit the enzymatic inactivation of endogenous incretin hormones, resulting in glucose-dependent insulin release and a decrease in glucagon secretion.
“Dipeptidyl peptidase 4 inhibitors (DPP-4i) are oral medications that inhibit the enzymatic inactivation of endogenous incretin hormones, resulting in glucose-dependent insulin release and a decrease in glucagon secretion.”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [141]
The Glucose-Lowering Therapies and Cardiovascular Outcomes and Heart Failure sections discuss DPP-4 inhibitors’ cardiovascular outcomes, but not how they work. Searches for incretin inactivation, glucose-dependent insulin release, and reduced glucagon secretion found no passage addressing the claimed mechanism. The supplied passages have no page numbers. (LLM, conf=0.74)
Experimental — accuracy not yet measured
The risk of cardiac arrhythmias or sudden cardiac death in patients with diabetes is most often related to the presence and severity of underlying cardiovascular disease.
“The risk of cardiac arrhythmias or sudden cardiac death (SCD) in patients with diabetes is most often related to the presence and severity of underlying CVD, but diabetes-related factors may induce arrhythmias independently of CV comorbidities.157,[573][574][575][576][577]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [157]
Diabetes-related factors may induce arrhythmias independently of cardiovascular comorbidities.
“The risk of cardiac arrhythmias or sudden cardiac death (SCD) in patients with diabetes is most often related to the presence and severity of underlying CVD, but diabetes-related factors may induce arrhythmias independently of CV comorbidities.157,[573][574][575][576][577]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [157]
Diabetes may increase the risk of cardiac arrhythmias via several factors including associated cardiovascular risk factors, cardiovascular disease, and diabetes-associated factors such as glucose control or diabetic neuropathy.
“Diabetes may increase the risk of cardiac arrhythmias via several factors including: associated CV risk factors (e.g.hypertension), CVD (i.e.CAD, prior MI, HF, or stroke), and diabetes-associated factors such as glucose control or diabetic neuropathy.157,[569][570][571][572]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [157]

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European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
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Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
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Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
Perkovic, V., Jardine, M. J., Neal, B., Bompoint, S., Heerspink, H. J. L., Charytan, D. M., Edwards, R., Agarwal, R., Bakris, G., Bull, S., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1811744 · Cited by 6,189 · cited 4× · see citing works
“Additional data from the CREDENCE trial with canagliflozin showed a 39% reduction in hospitalization for heart failure, and 31% reduction in the composite of cardiovascular death or hospitalization for heart failure, in a diabetic kidney disease population with albuminuria (UACR of >300 to 5,000 mg/g) (187).”
BackgroundMethodInfluential
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease
Sabatine, M. S., Giugliano, R. P., Keech, A. C., Honarpour, N., Wiviott, S. D., Murphy, S. A., Kuder, J. F., Wang, H., Liu, T., Wasserman, S. M., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1615664 · Cited by 6,138 · see citing works
Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet
Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., Simons-Morton, D. G., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200101043440101 · Cited by 5,638 · see citing works
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Optimal Medical Therapy with or without PCI for Stable Coronary Disease
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Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes
Cannon, C. P., Blazing, M. A., Giugliano, R. P., McCagg, A., White, J. A., Theroux, P., Darius, H., Lewis, B. S., Ophuis, T. O., Jukema, J. W., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1410489 · Cited by 4,487 · see citing works
2020 International Society of Hypertension Global Hypertension Practice Guidelines
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., Tomaszewski, M., et al. (2020) · Hypertension · doi:10.1161/hypertensionaha.120.15026 · Cited by 4,132 · cited 1× · see citing works
“Elevated values should preferably be con ﬁ rmed on a separate day; however, in patients with cardiovascular disease and blood pressure $ 180/110 mmHg, it is reasonable to diagnose hypertension at a single visit (18).”
Background
Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis
Ettehad, D., Emdin, C. A., Kiran, A., Anderson, S. G., Callender, T., Emberson, J., Chalmers, J., Rodgers, A., & Rahimi, K. (2016) · The Lancet · doi:10.1016/s0140-6736(15)01225-8 · Cited by 3,755 · see citing works
Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome
Schwartz, G. G., Steg, P. G., Szarek, M., Bhatt, D. L., Bittner, V. A., Diaz, R., Edelberg, J. M., Goodman, S. G., Hanotin, C., Harrington, R. A., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1801174 · Cited by 3,634 · see citing works
Effect of a multifactorial intervention on mortality in type 2 diabetes
Gæde, P., Lund-Andersen, H., Parving, H.-H., & Pedersen, O. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0706245 · Cited by 3,489 · cited 1× · see citing works
“ASCVD morbidity and mortality have decreased (3,4).”
Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia
Bhatt, D. L., Steg, P. G., Miller, M., Brinton, E. A., Jacobson, T. A., Ketchum, S. B., Doyle, R. T., Juliano, R. A., Jiao, L., Granowitz, C., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1812792 · Cited by 3,317 · see citing works
Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy
The AIM-HIGH Investigators (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1107579 · Cited by 2,911 · see citing works
Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes
The Look AHEAD Research Group (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1212914 · Cited by 2,908 · see citing works
SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials
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“SGLT2 inhibitors also reduce risk of heart failure hospitalization and progression of kidney disease in patients with established ASCVD, multiple risk factors for ASCVD, or albuminuric kidney disease (203,204).”
Background
Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus
(2010) · New England Journal of Medicine · doi:10.1056/nejmoa1001282 · Cited by 2,837 · see citing works
Statins and risk of incident diabetes: A collaborative meta-analysis of randomised statin trials
Sattar, N., Preiss, D., Murray, H. M., Welsh, P., Buckley, B. M., de Craen, A. J., Seshasai, S. R. K., McMurray, J. J., Freeman, D. J., Jukema, J. W., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(09)61965-6 · Cited by 2,436 · see citing works
Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome
Pfeffer, M. A., Claggett, B., Diaz, R., Dickstein, K., Gerstein, H. C., Køber, L. V., Lawson, F. C., Ping, L., Wei, X., Lewis, E. F., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1509225 · Cited by 2,409 · see citing works
Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice
Brown, M. A., Magee, L. A., Kenny, L. C., Karumanchi, S. A., McCarthy, F. P., Saito, S., Hall, D. R., Warren, C. E., Adoyi, G., & Ishaku, S. (2018) · Hypertension · doi:10.1161/hypertensionaha.117.10803 · Cited by 2,089 · see citing works
A Randomized Trial of Therapies for Type 2 Diabetes and Coronary Artery Disease
(2009) · New England Journal of Medicine · doi:10.1056/nejmoa0805796 · Cited by 1,939 · see citing works
Sotagliflozin in patients with diabetes and recent worsening heart failure
Bhatt, D. L., Szarek, M., Steg, P. G., Cannon, C. P., Leiter, L. A., McGuire, D. K., Lewis, J. B., Riddle, M. C., Voors, A. A., Metra, M., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2030183 · Cited by 1,868 · see citing works
Effects of extended-release niacin with laropiprant in high-risk patients
The HPS2-THRIVE Collaborative Group (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1300955 · Cited by 1,668 · see citing works
Cholesterol Lowering With Simvastatin Improves Prognosis of Diabetic Patients With Coronary Heart Disease: A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S)
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Effects of aspirin for primary prevention in persons with diabetes mellitus
The ASCEND Study Collaborative Group (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1804988 · Cited by 1,189 · see citing works
Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk
Nicholls, S. J., Lincoff, A. M., Garcia, M., Bash, D., Ballantyne, C. M., Barter, P. J., Davidson, M. H., Kastelein, J. J. P., Koenig, W., McGuire, D. K., et al. (2020) · JAMA · doi:10.1001/jama.2020.22258 · Cited by 1,028 · cited 1× · see citing works
“As an example, the addition of 4 g per day of a carboxylic acid formulation of the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (n-3 carboxylic acid) to statin therapy in patients with atherogenic dyslipidemia and high cardiovascular risk, 70% of whom had diabetes, did not reduce the risk…”
Background
Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis
Xie, X., Atkins, E., Lv, J., Bennett, A., Neal, B., Ninomiya, T., Woodward, M., MacMahon, S., Turnbull, F., Hillis, G. S., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00805-3 · Cited by 980 · see citing works
Achievement of Goals in U.S. Diabetes Care, 1999–2010
Ali, M. K., Bullard, K. M., Saaddine, J. B., Cowie, C. C., Imperatore, G., & Gregg, E. W. (2013) · New England Journal of Medicine · doi:10.1056/nejmsa1213829 · Cited by 979 · see citing works
Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline
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2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement
Stergiou, G. S., Palatini, P., Parati, G., O’Brien, E., Januszewicz, A., Lurbe, E., Persu, A., Mancia, G., Kreutz, R., & on behalf of the European Society of Hypertension Council and the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability (2021) · Journal of Hypertension · doi:10.1097/hjh.0000000000002843 · Cited by 859 · see citing works
Blood Pressure Lowering in Type 2 Diabetes: A Systematic Review and Meta-analysis
Emdin, C. A., Rahimi, K., Neal, B., Callender, T., Perkovic, V., & Patel, A. (2015) · JAMA · doi:10.1001/jama.2014.18574 · Cited by 854 · see citing works
Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease
Yusuf, S., Bosch, J., Dagenais, G., Zhu, J., Xavier, D., Liu, L., Pais, P., López-Jaramillo, P., Leiter, L. A., Dans, A., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1600176 · Cited by 848 · see citing works
Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects
Wackers, F. J. T., Young, L. H., Inzucchi, S. E., Chyun, D. A., Davey, J. A., Barrett, E. J., Taillefer, R., Wittlin, S. D., Heller, G. V., Filipchuk, N., et al. (2004) · Diabetes Care · doi:10.2337/diacare.27.8.1954 · Cited by 791 · see citing works
Comparison of the Effects of Glucagon-Like Peptide Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors for Prevention of Major Adverse Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis of Cardiovascular Outcomes Trials
Zelniker, T. A., Wiviott, S. D., Raz, I., Im, K., Goodrich, E. L., Furtado, R. H. M., Bonaca, M. P., Mosenzon, O., Kato, E. T., Cahn, A., et al. (2019) · Circulation · doi:10.1161/circulationaha.118.038868 · Cited by 781 · see citing works
Heart Failure With Reduced Ejection Fraction: A Review
Murphy, S. P., Ibrahim, N. E., & Januzzi, J. L. (2020) · JAMA · doi:10.1001/jama.2020.10262 · Cited by 769 · cited 1× · see citing works
“b-Blockers are indicated in the setting of prior MI, active angina, or HfrEF but have not been shown to reduce mortality as blood pressure–lowering agents in the absence of these conditions (24,67,68).”
Background
Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial
Connolly, S. J., Eikelboom, J. W., Bosch, J., Dagenais, G., Dyal, L., Lanas, F., Metsarinne, K., O'Donnell, M., Dans, A. L., Ha, J.-W., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)32458-3 · Cited by 754 · see citing works
Diabetes and hypertension: a position statement by the American Diabetes Association
de Boer, I. H., Bangalore, S., Benetos, A., Davis, A. M., Michos, E. D., Muntner, P., Rossing, P., Zoungas, S., & Bakris, G. (2017) · Diabetes Care · doi:10.2337/dci17-0026 · Cited by 714 · see citing works
Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials
Palmer, S. C., Tendal, B., Mustafa, R. A., Vandvik, P. O., Li, S., Hao, Q., Tunnicliffe, D., Ruospo, M., Natale, P., Saglimbene, V., et al. (2021) · BMJ · doi:10.1136/bmj.m4573 · Cited by 679 · cited 1× · see citing works
“Meta-analyses of the trials reported to date suggest that GLP-1 receptor agonists and SGLT2 inhibitors reduce risk of atherosclerotic major adverse cardiovascular events to a comparable degree in patients with type 2 diabetes and established ASCVD (201,202).”
Result
Less-Tight versus Tight Control of Hypertension in Pregnancy
Magee, L. A., von Dadelszen, P., Rey, E., Ross, S., Asztalos, E., Murphy, K. E., Menzies, J., Sanchez, J., Singer, J., Gafni, A., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1404595 · Cited by 672 · see citing works
Atenolol in hypertension: is it a wise choice?
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Effect of Lowering LDL Cholesterol Substantially Below Currently Recommended Levels in Patients With Coronary Heart Disease and Diabetes
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“Interestingly, a post hoc analysis has found that intensive blood pressure lowering increased the risk of incident chronic kidney disease in both ACCORD BP and SPRINT, with the absolute risk of incident chronic kidney disease being higher in individuals with type 2 diabetes (36).”
Background
Cardiovascular and Renal Outcomes of Renin–Angiotensin System Blockade in Adult Patients with Diabetes Mellitus: A Systematic Review with Network Meta-Analyses
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Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension
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Metformin in Heart Failure
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Iliescu, R., Lohmeier, T. E., Tudorancea, I., Laffin, L., & Bakris, G. L. (2015) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00246.2015 · Cited by 50 · see citing works
Advancing Digital Health Interventions as a Clinically Applied Science for Blood Pressure Reduction: A Systematic Review and Meta-analysis
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Authors: American Diabetes Association Professional Practice Committee
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2021-12-16
Volume: 45
Issue: Supplement_1
Pages: S144-S174
ISSN: 0149-5992 (ISSN-L)
DOI: 10.2337/dc22-s010
OpenAlex: W4200347668
Cited by: 869
References: 79
Citations by year: 2026: 26 · 2025: 84 · 2024: 136 · 2023: 210 · 2022: 222 · 2021: 62 · 2020: 72 · 2019: 41 · 2018: 15 · 2013: 1
FWCI: 24.14
Type: journal article
Language: en
Update notices: addendum (2022-05-31)
correction (2022-03-07)
Open access: bronze
doi.org
Licence: www.diabetesjournals.org/content/license (vor)
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: cardiovascular disease, cardiovascular risk management, diabetes mellitus, clinical guidelines, quality of care
MeSH terms: Cardiovascular Diseases, Diabetes Mellitus, Endocrinology, Humans, Reference Standards, Societies, Medical, Standard of Care

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10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2022

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