AHA/ACC Scientific Statement:Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations

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GRUNDY ET AL., Assessment of Cardiovascular Risk
J Am Coll Cardiol 1999;34:1348--59

AHA/ACC Scientific Statement: Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations

A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology

XI. Diabetes Mellitus as a Special Case in Risk Assessment

That diabetes mellitus is a major risk factor for CVD is well established.² Both type 1 diabetes³³ and type 2 diabetes³⁴ confer a heightened risk for CVD. Type 2 diabetes is of particular concern because it is so common and usually occurs in persons of advancing age, when multiple other risk factors coexist. There is a growing consensus that most patients with diabetes mellitus, especially those with type 2 diabetes, belong in a category of high short-term risk. When the risk factors of diabetic patients are summed, their risk often approaches that of patients with established CHD.³⁵ The absolute risk of patients with type 2 diabetes usually exceeds the Framingham score for hyperglycemia because other risk factors almost always coexist. Another reason to elevate the patient with diabetes to a higher risk category than suggested by Framingham scoring is the poor prognosis of these patients once they develop CHD.³⁶ These factors point to the need to intensify the management of coexisting risk factors in patients with diabetes,^7, ³⁷ These considerations about the very high risk of patients with diabetes apply to ethnic groups that have a relatively high population risk for CHD. The inclusion of patients with type 2 diabetes in the very-high-risk category may not be appropriate when they belong to ethnic groups with a low population risk.

American College of Cardiology

Helping Cardiovascular Professionals Learn. Advance. Heal.

GRUNDY ET AL., Assessment of Cardiovascular Risk J Am Coll Cardiol 1999;34:1348--59