Cardio Metabolic Care
What is cardiometabolic disease?
‘Cardiometabolic disease’ is a term initially used by Pescatello in exercise physiology literature, and is essentially a simplification and modernization of Reaven’s hypothesis. She described a clustering of disorders (abdominal adiposity, hypertension, dyslipidemia, hyperinsulinemia and glucose intolerance) that together lead to cardiovascular disease (CVD) and type 2 diabetes. She observed that there had been a sudden increase in overweight and obesity but only a slight increase in food intake, suggesting that physical activity was more important than calorie intake in causing obesity. She hypothesized that increases in low to moderate physical activity may result in significant health gains, including the prevention of CVD and the prevention of diabetes, without preventing overweight or obesity, and that this might be a more realistic public health target than unrealistic reductions in energy intake. More recently, the term ‘cardiometabolic disease’ has been extended to describe the interface between cardiology and diabetes, and to describe pharmacological interventions that would reduce cardiovascular and metabolic endpoints.
What is the ideal cardiometabolic intervention?
The ideal cardiometabolic intervention would reduce weight and abdominal adiposity, lower LDL cholesterol and triglycerides, increase HDL cholesterol, lower blood pressure, reduce insulin resistance and improve glucose tolerance. The gold standard would be proven reduction of cardiovascular events in a double-blind, placebo-controlled trial, proven reduction in the development of diabetes and/or sustained reduction in HbA1c. For maximum applicability it should have no side effects or contraindications.
Currently there are many available medications.
Diabetes is a disease in which blood glucose, or blood sugar, levels are too high. Glucose comes from the foods. Insulin is a hormone that helps the glucose get into the cells to give them energy. With type 1 diabetes, the body does not make insulin. With type 2 diabetes, the more common type, the body does not make or use insulin well.
Hypertension is another name for high blood pressure. It can lead to severe complications and increases the risk of heart disease, stroke, and death. Blood pressure is the force exerted by the blood against the walls of the blood vessels. The pressure depends on the work being done by the heart and the resistance of the blood vessels.