Alhabeeb Waleed, Elasfar Abdelfatah, Kinsara Abdulhalim J, Aljizeeri Ahmed, Jelaidan Ibrahim, Alghalayini Kamal, AlKheraiji Mohammed F, Akbar Mousa, Lawand Sameh, Alyousif Sarah M, Alsifri Saud, Hassan Taher
Department of Cardiac Sciences, King Saud University, Riyadh, Saudi Arabia.
Cardiology Department, Hamad Medical Corporation, Qatar.
J Saudi Heart Assoc. 2024 Dec 5;36(4):385-407. doi: 10.37616/2212-5043.1407. eCollection 2024.
Cardiovascular disease (CVD) and diabetes mellitus are prominent public health concerns in Saudi Arabia owing to their increasingly high prevalence and burden. Based on this, the Saudi Heart Association (SHA) set out to develop an official position statement on CVD and diabetes mellitus, with a focus on the prevention and management of these conditions and relevant special populations in the context of Saudi Arabia.
A multidisciplinary panel of experts met under the auspices of the SHA in a series of meetings to review and discuss available evidence on the prevention and management of comorbid CVD and diabetes mellitus. Specialized subcommittees reviewed the data and offered context-specific recommendations (taking into account Saudi population characteristics, local healthcare system, available resources and medical expertise), which were later approved by the full expert panel.
The prevalence of diabetes mellitus and CVD is alarming in the Saudi Arabian population. Diabetes mellitus and CVD are interconnected on several levels, including cellular and molecular events as well as epigenetic and genetic mechanisms. Screening for CVD is a priority for patients with diabetes and concomitant risk factors. The expert panel also recommends aggressive management of high blood pressure and dyslipidemia in addition to lifestyle changes and achieving glycemic targets for the prevention of CVD in patients with diabetes. Some glucose-lowering drug classes, namely SGLT2-inhibitors and GLP-1 receptor agonists, offer significant benefits on the level of cardiovascular risk reduction and are thus a powerful addition to the clinical management armamentarium in CVD and diabetes. Special consideration is also advised for patient populations with distinct clinical presentation and needs, such as coronary artery disease, heart failure, and chronic kidney disease, among others.
心血管疾病(CVD)和糖尿病是沙特阿拉伯突出的公共卫生问题,因其患病率和负担日益增加。基于此,沙特心脏协会(SHA)着手制定一份关于心血管疾病和糖尿病的官方立场声明,重点关注沙特阿拉伯背景下这些疾病的预防、管理以及相关特殊人群。
一个多学科专家小组在沙特心脏协会的主持下召开了一系列会议,以审查和讨论关于合并心血管疾病和糖尿病的预防与管理的现有证据。专门的小组委员会审查了数据并提出了针对具体情况的建议(考虑到沙特人群特征、当地医疗系统、可用资源和医学专业知识),这些建议随后得到了整个专家小组的批准。
糖尿病和心血管疾病在沙特阿拉伯人群中的患病率令人担忧。糖尿病和心血管疾病在多个层面相互关联,包括细胞和分子事件以及表观遗传和遗传机制。对患有糖尿病和伴有危险因素的患者而言,筛查心血管疾病是首要任务。专家小组还建议,除了改变生活方式和实现血糖目标以预防糖尿病患者的心血管疾病外,还要积极控制高血压和血脂异常。某些降糖药物类别,即钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂,在降低心血管风险方面具有显著益处,因此是心血管疾病和糖尿病临床管理手段的有力补充。对于具有独特临床表现和需求的患者群体,如冠状动脉疾病、心力衰竭和慢性肾脏病等,也建议给予特别考虑。