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Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. (released august 25th, 2015), check A JOINT Scientific Statement From the American Heart Association and the American Diabetes Association

Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification.

Diabetes mellitus, defined by elevated glycemic markers, is understood as a major risk factor for cardiovascular disease (CVD).

CVDs, can result, due to disorders of circulation called Thromboses. Thromboses are conditions that arise out of local coagulation or clotting of the blood in a part of the circulatory system. There are two types: venous and arterial types and gong by the name they occur in veins or arteries respectively. Thromboses in veins may be referred to as DVT (deep vein thrombosis) which causes Pulmonary Embolism (PE), which can be fatal. Arterial thrombosis is a common cause of acute myocardial infarction (heart attack), ischemic stroke and limb gangrene.

What is prophylactic medication?

When a few drugs are taken as a preventive measure the therapy is usually referred to as drug being given as Prophylactic.

What does this mean?

Prophylactic: A preventive measure. The word comes from the Greek for “an advance guard,” an apt term for a measure taken to fend off a disease or another unwanted consequence. A prophylactic therapy is a medication or a treatment designed and used to prevent a disease from occurring.

Quick look at Medications for the heart:

angiotensin-converting enzyme (ACE) inhibitors: relax blood vessels by preventing the formation of the vasoconstrictor angiotensin II. ACE inhibitors are commonly used to treat hypertension and heart failure.

angiotension II receptor blockers (ARBs): lower blood pressure by inhibit- ing the vasoconstrictor angiotension II from binding its action sites.

antiarrhythmic drugs: restore normal sinus rhythm via various mechanisms to treat cardiac arrhythmias.

anticoagulants: prevent the formation of blood clots. Examples are warfarin and heparin.

antihyperlipidemics: lower “bad” and or raise “good” cholesterol levels to reduce the risk of heart attack or stroke.

beta-blockers: depress the heart rate and force of heart contractions by decreas- ing the effectiveness of the nerve impulses to the cardiovascular system. They typically are prescribed to treat angina pectoris, hypertension, and cardiac arrhythmias.

calcium channel blockers (CCBs): decrease myocardial oxygen demand by inhibiting the flow of calcium to smooth muscle cells of the heart, which causes arterial relaxation. CCBs are used to treat angina, hypertension, and heart failure.

diuretics (dye ur REH ticks): promote the excretion of sodium and water as urine; they are used in the treatment of hypertension and heart failure.

nitrates (antianginals): relax blood vessels and reduce myocardial oxygen consumption to lessen the pain of angina pectoris; also used to treat hyper- tension and heart failure.

 Thrombolytics (antiplatelets) : aid in the dissolution of blood clots. “Clot busters” are used to treat obstructing coronary thrombi (clots).

Antiplatelet and anticoagulation drugs:

Anticoagulants and antiplatelet agents are medicines that reduce blood clotting in an artery, a vein or the heart. Blood clots can block the blood flow to your heart muscle and cause a heart attack. They can also block blood flow to your brain, causing a stroke. Anticoagulants (sometimes known as “blood thinners”) are drugs that are given to prevent your blood from clotting or prevent existing clots from getting larger.

Antiplatelet agents: These drugs, such as aspirin, keep blood clots from forming. Many doctors now prescribe aspirin to heart patients for this reason. Some common names are such as Aspirin, Ticlopidine, Clopidogrel or Dipyridamole

When two of the above are prescribed, it is referred to as Dual antiplatelet therapy.

Recent Recommendations (released august 25th, 2015), in an Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence A Scientific Statement From the American Heart Association and the American Diabetes Association advises:

Low-dose aspirin (75–162 mg/d) is reasonable among those with a 10-year CVD risk of at least 10% and without an increased risk of bleeding (ACC/AHA Class IIa; Level of Evidence B) (ADA Level of Evidence C).

Low-dose aspirin is reasonable in adults with diabetes mellitus at intermediate risk (10-year CVD risk, 5%–10%) (ACC/AHA Class IIb;)

**AHA- (American Heart Association); ADA (American Diabetes Association)

Does aspirin help prevent health problems? — Yes, aspirin can prevent a few different health problems in certain people. For example, in people who have had a heart attack or stroke, aspirin can help prevent another heart attack or stroke, or even death. Studies also suggest that aspirin can prevent heart attacks in people who have never had a heart attack or any type of heart or blood vessel disease. Plus, aspirin might protect against some forms of cancer and help people live longer. The type of cancer that aspirin seems to help most with is cancer of the colon or rectum (the lower part of the bowel).

What health problems aspirin can cause if not taken under supervision?— Yes, aspirin is a scheduled high drug and has its downside. It can cause serious internal bleeding. When aspirin causes bleeding, it is usually in the stomach or intestines. But bleeding can also happen in other parts of the body, such as the brain.

The risk of bleeding while taking aspirin is not the same for everyone. Some people have a higher risk than others.

You are more likely to have bleeding episode in following cases:

If you have had ulcers in your stomach or intestines (called peptic ulcers) and may be 65 years old or above!

Take high doses of medicines called nonsteroidal antiinflammatory drugs (NSAIDs), such as naproxen (sample brand name: Aleve) or ibuprofen (sample brand names: Advil, Motrin)

Also if you are using medicines called corticosteroids in the form of pills or shots (It doesn’t matter if you use these medicines in a cream or lotion that you put on your skin.)

Take medicines called “anti-coagulants” or blood thinners, such as:

Warfarin, Dabigatran, Apixaban or Rivaroxaban

How does aspirin prevent health problems? — When it comes to problems that affect the heart or blood vessels, aspirin can help because it helps prevent blood clots. Heart attacks and some strokes happen when blood clots form inside arteries. Aspirin helps keep that from happening. When it comes to cancer, experts aren’t sure why aspirin might help, but results of several studies suggest it does!

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