O8 Use of therapeutic strategies with cardiovascular benefit in a population of patients with type 2 diabetes in follow up by cardiologist

Abstract

Introduction: patients (p) with type 2 diabetes mellitus (DM2) have an increased risk of presenting cardiovascular (CV) complications, which is also the main cause of death in this population. Certain lifestyle interventions and pharmacological treatments have shown a reduction in CV events, which is why they are among the first line of recommendations in the main treatment guidelines.

Objectives: evaluate adherence to a healthy lifestyle and the use of pharmacological treatments with cardiovascular benefit in a population of p with DM2. Observe if there are differences between p with and without cardiovascular disease (CVD).

Materials and methods: cross-sectional, observational and multicenter study. P attended in the cardiology office were consecutively recorded from May to July 2019. Of the total p evaluated with DM2, the first two of each day of care entered the study. A healthy lifestyle was defined as: 1) physical activity (physical activity >150 minutes/week); 2) normal waist circumference (WC) (<88 cm in women and <102 cm in men; 3) without obesity (BMI <30 kg/m2); 4) intake of >5 servings of fruits and vegetables/day; 5) non-smoking and pharmacological strategies with CV benefit. 1) use of statins; 2) use of iSGLT2 and ARGLP-1; 3) use of acetylsalicylic acid (ASA) in secondary prevention. Means, medians, and standard deviations were used as appropriate. T test to compare means and chi square or Fisher test for dichotomous variables.

Results: 649 p. 58.5% men and age 64.7 years (+/- 10.5). The baseline characteristics are seen in Table 1. In relation to healthy lifestyle habits, 42.4% were physically active, 91.2% were non-smokers, 21.5% had normal CP, 39.1% BMI <30 kg/ m2 and 49.9% consumed 5 or more servings of fruits and vegetables/day. Regarding pharmacological treatment, 70.4% received statins, 9.8% iSGLT2 and 3% ARGLP-1,
while the use of ASA in patients with CVD was 72.9%. In relation to the differences between the groups with or without CVD, those with CVD were less frequently smokers (93.2% CVD – 89.5% S/CVD p=0.034), they had a lower prevalence of obesity (BMI<30 kg /m2: 45.4% CVD vs 34.9% S/CVD p=0.002) and greater use of statins (81.4% C/CVD and 60.5% p=0.00001) and iSGLT2 (12.8 % ECV vs 7.1% S/ECV p=0.006), with no differences observed in the rest of the variables (Figure).

Conclusions: with the exception of smoking, we observed low adherence to healthy lifestyle measures and use of pharmacological treatments with cardiovascular benefit. Despite being a population with high CV risk, patients without CVD underused pharmacological treatments with CV benefit and the prevalence of obesity was higher than in patients with CVD.