XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Blaha, MD, MPH Stephanie E. Chiuve, ScD Mary Cushman, MD, MSc, FAHA Sandeep R. Das, MD, MPH, FAHA Rajat Deo, MD, MTR Sarah D. de Ferranti, MD, MPH James Floyd, MD, MS Myriam Fornage, PhD, FAHA Cathleen Gillespie, MS Carmen R. Isasi, MD, PhD, FAHA Monik C. Jiménez, ScD, SM Lori Chaffin Jordan, MD, PhD Suzanne E. Judd, PhD Daniel Lackland, DrPH, FAHA Judith H. Lichtman, PhD, MPH, FAHA Lynda Lisabeth, PhD, MPH, FAHA Simin Liu, MD, ScD, FAHA Chris T. Longenecker, MD Rachel H. Mackey, PhD, MPH, FAHA Kunihiro Matsushita, MD, PhD, FAHA Dariush Mozaffarian, MD, DrPH, FAHA Michael E. Mussolino, PhD, FAHA Khurram Nasir, MD, MPH, FAHA Robert W. Neumar, MD, PhD, FAHA Latha Palaniappan, MD, MS, FAHA Dilip K. Pandey, MBBS, MS, PhD, FAHA Ravi R. Thiagarajan, MD, MPH Mathew J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Rodriguez, MD, MPH, FAHA Gregory A. Roth, MD, MPH Wayne D. Rosamond, PhD, FAHA Comilla Sasson, MD, PhD, FAHA Amytis Towfighi, MD Connie W. Tsao, MD, MPH Melanie B. Turner, MPH Salim S. Virani, MD, PhD, FAHA Jenifer H. Voeks, PhD Joshua Z. Willey, MD, MS John T. Wilkins, MD Jason HY. Wu, MSc, PhD, FAHA Heather M. Alger, PhD Sally S. Wong, PhD, RD, CDN, FAHA Paul Muntner, PhD, MHSc On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart Disease and Stroke Statistics—2017 Update

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Author(s): Writing Group Members; Mozaffarian, Dariush; Benjamin, Emelia J; Go, Alan S; Arnett, Donna K; Blaha, Michael J; Cushman, Mary; Das, Sandeep R; de Ferranti, Sarah; Despres, Jean-Pierre; Fullerton, Heather J; Howard, Virginia J; Huffman, Mark D; Isasi, Carmen R; Jimenez, Monik C; Judd, Suzanne E; Kissela, Brett M; Lichtman, Judith H; Lisabeth, Lynda D; Liu, Simin; Mackey, Rachel H; Magid, David J; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Muntner, Paul; Mussolino, Michael E; Nasir, Khurram; Neumar, Robert W; Nichol, Graham; Palaniappan, Latha; Pandey, Dilip K; Reeves, Mathew J; Rodriguez, Carlos J; Rosamond, Wayne; Sorlie, Paul D; Stein, Joel; Towfighi, Amytis; Turan, Tanya N; Virani, Salim S; Woo, Daniel; Yeh, Robert W; Turner, Melanie B; American Heart Association Statistics Committee; Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association

March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Benjamin, MD, ScM, FAHA, Chair Paul Muntner, PhD, MHS, FAHA, Vice Chair Alvaro Alonso, MD, PhD, FAHA Marcio S. Bittencourt, MD, PhD, MPH Clifton W. Callaway, MD, FAHA April P. Carson, PhD, MSPH, FAHA Alanna M. Chamberlain, PhD Alexander R. Chang, MD, MS Susan Cheng, MD, MMSc, MPH, FAHA Sandeep R. Das, MD, MPH, MBA, FAHA Francesca N. Delling, MD, MPH Luc Djousse, MD, ScD, MPH Mitchell S.V. Elkind, MD, MS, FAHA Jane F. Ferguson, PhD, FAHA Myriam Fornage, PhD, FAHA Lori Chaffin Jordan, MD, PhD, FAHA Sadiya S. Khan, MD, MSc Brett M. Kissela, MD, MS Kristen L. Knutson, PhD Tak W. Kwan, MD, FAHA Daniel T. Lackland, DrPH, FAHA Tené T. Lewis, PhD Judith H. Lichtman, PhD, MPH, FAHA Chris T. Longenecker, MD Matthew Shane Loop, PhD Pamela L. Lutsey, PhD, MPH, FAHA Seth S. Martin, MD, MHS, FAHA Kunihiro Matsushita, MD, PhD, FAHA Andrew E. Moran, MD, MPH, FAHA Michael E. Mussolino, PhD, FAHA Martin O’Flaherty, MD, MSc, PhD Ambarish Pandey, MD, MSCS Amanda M. Perak, MD, MS Wayne D. Rosamond, PhD, MS, FAHA Gregory A. Roth, MD, MPH, FAHA Uchechukwu K.A. Sampson, MD, MBA, MPH, FAHA Gary M. Satou, MD, FAHA Emily B. Schroeder, MD, PhD, FAHA Svati H. Shah, MD, MHS, FAHA Nicole L. Spartano, PhD Andrew Stokes, PhD David L. Tirschwell, MD, MS, MSc, FAHA Connie W. Tsao, MD, MPH, Vice Chair Elect Mintu P. Turakhia, MD, MAS, FAHA Lisa B. VanWagner, MD, MSc, FAST John T. Wilkins, MD, MS, FAHA Sally S. Wong, PhD, RD, CDN, FAHA Salim S. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association

Each chapter listed in the Table of Contents (see next page) is a hyperlink to that chapter. The reader clicks the chapter name to access that chapter.

Each chapter listed here is a hyperlink. Click on the chapter name to be taken to that chapter. 

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together in a single document the most up-to-date statistics related to heart disease, stroke, and the cardiovascular risk factors listed in the AHA’s My Life Check - Life’s Simple 7 (Figure1), which include core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure [BP], and glucose control) that contribute to cardiovascular health. The Statistical Update represents …

Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association.

Epidemiological evidence for the link between sleep duration and high blood pressure: A systematic review and meta-analysis

The quantitative associations between prehypertension or its separate blood pressure (BP) ranges and the risk of main cardiovascular diseases (CVDs) have not been reliably documented. We performed a comprehensive search of PubMed (1966 to June 2012) and the Cochrane Library (1988 to June 2012) without language restrictions. Prospective studies were included if they reported multivariate-adjusted risk ratios (RRs) and corresponding 95 % confidence intervals (CIs) of desirable outcomes, including fatal or non-fatal incident stroke, coronary heart disease, myocardial infarction (MI) or total CVD events, with respect to prehypertension or its separate BP ranges (low range: 120–129/80–84 mmHg; high range: 130–139/85–89 mmHg) at baseline with normal BP (<120/80 mmHg) as reference. Pooled RRs were estimated using a random-effects model or a fixed-effects model. Twenty-nine articles met our inclusion criteria, with 1,010,858 participants. Both low-range and high-range prehypertension were associated with a greater risk of developing or dying of total CVD (low-range: RR: 1.24; 95 % CI: 1.10 to 1.39; high range: RR: 1.56; 95 % CI: 1.36 to 1.78), stroke (low-range: RR: 1.35; 95 % CI: 1.10 to 1.66; high-range: RR: 1.95; 95 % CI: 1.69 to 2.24) and myocardial infarction (MI) (low range: RR: 1.43; 95 % CI: 1.10 to 1.86; high range: RR: 1.99; 95 % CI: 1.59 to 2.50). The whole range prehypertension had a 1.44-fold (95 % CI: 1.35 to 1.53), 1.73-fold (95 % CI: 1.61 to 1.85), and 1.79-fold (95 % CI: 1.45 to 2.22) risk of total CVD, stroke, and MI, respectively. There was no evidence of publication bias. Prehypertensive patients have a greater risk of incident stroke, MI and total CVD events. The impact was markedly different between the low and high prehypertension ranges.

Association between pre-hypertension and cardiovascular outcomes: a systematic review and meta-analysis of prospective studies.

Background
The Body Mass Index (BMI) has long been used as an anthropometric measurement. Waist circumference (WC) and waist-to-height ratio (WHtR) have been proposed as alternatives to BMI. Recently, two new anthropometric indices, the A Body Shape Index (ABSI) and Body Roundness Index (BRI) have been developed as possible improved alternatives to BMI and WC. The main research aim is to assess the capacity of the ABSI and BRI to identify subjects with diabetes mellitus (DM) and the secondary aim is to determine whether ABSI and/or BRI is superior to the traditional body indices (BMI, WC, and WHtR).

/pdf/a-body-shape-index-and-body-roundness-index-two-new-body-304kb5ia2z.pdf

A body shape index and body roundness index: two new body indices to identify diabetes mellitus among rural populations in northeast China

We investigated the prevalence and risk factors of prehypertension, as well as the predictors of progression from prehypertension to hypertension. To do this, we performed a systematic review and meta-analysis of cross-sectional and longitudinal studies, after unrestricted searches of PubMed and The Cochrane Library through September 2010. In addition, we reviewed references, major textbooks, and review articles. Pooled prevalence, standardized mean differences, and odds ratios were estimated by using a random-effects model. Twenty-six articles met our inclusion criteria; these included 20 cross-sectional and 6 longitudinal studies, with a total sample of 250,741 individuals. The overall pooled prevalence of prehypertension was 36%. The pooled prevalence among males was higher than that among females (40% vs 33%). The pooled standardized mean difference for body mass index was 1.37 (95% confidence interval [CI], 1.20-1.55); for total cholesterol, 8.08 (95% CI, 6.71-9.46); for low-density-lipoprotein cholesterol, 5.14 (95% CI, 3.09-7.18); and for fasting plasma glucose, 4.23 (95% CI, 3.28-5.18); all of which showed more significant results in females. The pooled odds ratio was 1.13 (95% CI, 0.93-1.37) for smoking and 0.98 (95% CI, 0.69-1.39) for drinking. In addition, factors such as older age at baseline, male sex, Mongolian race, and being overweight or obese were predictors of progression to hypertension, according to descriptive analysis. The prevalence of prehypertension was relatively high, especially for males. There were many modifiable risk factors associated with prehypertension, to which healthcare providers should pay more attention.

/pdf/prehypertension-a-meta-analysis-of-the-epidemiology-risk-2c3uu6bql2.pdf

Xiaofan Guo

Papers

Epidemiological evidence for the link between sleep duration and high blood pressure: A systematic review and meta-analysis

Association between pre-hypertension and cardiovascular outcomes: a systematic review and meta-analysis of prospective studies.

A body shape index and body roundness index: two new body indices to identify diabetes mellitus among rural populations in northeast China

Prehypertension: a meta-analysis of the epidemiology, risk factors, and predictors of progression.

Alcohol consumption and cardiovascular diseases in rural China.