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学科主题: 临床医学
题名:
Primacy of the 3B Approach to Control Risk Factors for Cardiovascular Disease in Type 2 Diabetes Patients
作者: CCMR-3B Study Investigators1; Ji, Linong1; Hu, Dayi2; Pan, Changyu3; Weng, Jianping4; Huo, Yong5; Ma, Changsheng6; Mu, Yiming3; Hao, Chuanming7; Ji, Qiuhe8; Ran, Xingwu9; Su, Benli10; Zhuo, Hanjing11; Fox, Keith A. A.12; Weber, Michael13; Zhang, Danyi11; CCMR Advisory Board1
关键词: Cardiovascular risk factor ; China ; Dyslipidemia ; Hyperglycemia ; Hypertension ; Type 2 diabetes
刊名: AMERICAN JOURNAL OF MEDICINE
发表日期: 2013-10-01
DOI: 10.1016/j.amjmed.2013.02.035
卷: 126, 期:10
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: CORONARY-HEART-DISEASE ; MYOCARDIAL-INFARCTION ; GENERAL-PRACTICE ; BLOOD-PRESSURE ; POPULATION ; MELLITUS ; PREVALENCE ; CHINA ; GUIDELINES ; PROGNOSIS
英文摘要:

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.

语种: 英语
项目资助者: Merck Sharp Dohme (China)
WOS记录号: WOS:000324469800030
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/49951
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland
2.Peking Univ, Peoples Hosp, Dept Endocrinol & Metab, Beijing 100044, Peoples R China
3.Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100044, Peoples R China
4.Beijing 301 Mil Gen Hosp, Dept Endocrinol, Beijing, Peoples R China
5.Sun Yat Sen Univ, Affiliated Hosp 3, Dept Endocrinol, Guangzhou 510275, Guangdong, Peoples R China
6.Peking Univ, Affiliated Hosp 1, Dept Cardiol, Beijing 100044, Peoples R China
7.Capital Med Univ, Beijing An Zhen Hosp, Dept Cardiol, Beijing, Peoples R China
8.Fudan Univ, Huashan Hosp, Dept Nephrol, Shanghai 200433, Peoples R China
9.Forth Mil Med Univ, Xi Jing Hosp, Dept Endocrinol, Xian, Peoples R China
10.Sichuan Univ, West China Hosp, Dept Endocrinol, Chengdu 610064, Peoples R China
11.Da Lian Med Univ, Affiliated Hosp, Dept Endocrinol, Dalian, Peoples R China
12.VitalStrateg Res Inst, Berwyn, PA USA
13.SUNY Downstate Coll Med, Dept Med, Brooklyn, NY USA

Recommended Citation:
CCMR-3B Study Investigators,Ji, Linong,Hu, Dayi,et al. Primacy of the 3B Approach to Control Risk Factors for Cardiovascular Disease in Type 2 Diabetes Patients[J]. AMERICAN JOURNAL OF MEDICINE,2013,126(10).
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