Recent changes in perspectives
In the 2013 ACC/AHA assessment of risk guidelines,
diabetes was considered as only one of the many
variables in its risk assessment equation rather than
a CHD risk equivalent .
The assertion that all patients with diabetes are
CHD equivalent has been controversial.
It is observed that acetylsalicylic acid do not
reduce CV events among patients with diabetes,
however it decrease events for those with
previous CV disease. Risk calculators can be
used to estimate overall CV risk for patients with
diabetes. The UKPDS risk engine is designed for
patients with diabetes and the Best Science
Medicine calculator predicts benefits with
The above discussion gives a varied perspective
to diabetes as a CHD equivalent. Although
diabetes does confer an increased risk of CV
events, it is not automatically equivalent to
having a previous CHD, and thus does not always
warrant aggressive pharmacotherapy. It is
important to take into account individual CV risk
before deciding on treatment for each patient.
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25th August 2016.