Treatment Regimen Treatment to Prevent CVD :
The Endocrine Society recommends: ÎApo B-containing lipoproteins (LDL and VLDL) be lowered in patients at metabolic risk to reduce risk for CVD (1⎟ ⊕⊕⊕⊕).
ÎLDL cholesterol (LDL-C) be the primary target of lipoprotein-lowering therapy (1⎟ ⊕⊕⊕⊕).
ÎNon-HDL-C be the secondary target (1⎟ ⊕⊕⊕).
ÎThe intensity of lipoprotein-lowering therapy be adjusted to the absolute 10-yr risk for CVD (1⎟ ⊕⊕) and that intensity of lipoprotein-lowering therapy further be adjusted to the absolute lifetime risk for CVD (2⎟ ⊕).
ÎIf HDL-C remains reduced after treatment of non-HDL-C, consideration be given to therapies designed to raise HDL-C (1⎟ ⊕⊕).
ÎElevated blood pressure be lowered (1⎟ ⊕⊕⊕⊕) to a target of less than 140/90 mm Hg (or < 130/80 in individuals with diabetes or chronic kidney disease) (1⎟ ⊕⊕⊕) to reduce the risk for CVD.
ÎIf weight loss and lifestyle modifications do not lower blood pressure sufficiently, medications be instituted (1⎟ ⊕⊕⊕).
ÎLifestyle management be considered first-line therapy for patients at increased metabolic risk (1⎟ ⊕).
ÎThe prothrombotic state be treated with lifestyle therapies to reduce risk for CVD (1⎟ ⊕).
ÎLow dose aspirin prophylaxis be considered for primary prevention of CVD (75-162 mg/d) in individuals at metabolic risk > age 40 with a 10-yr risk > 10%, if there are no contraindications (1⎟ ⊕⊕⊕).
Treatment to Prevent T2DM :
The Endocrine Society recommends: ÎPriority be given to reducing risk for diabetes with lifestyle therapies rather than drug therapies (1⎟ ⊕⊕⊕).
ÎAt risk patients be maintained on a balanced clinical program of weight management that includes regular, moderate-intensity physical activity, caloric intake monitoring, and formal behavior modification (1⎟ ⊕⊕).
ÎPhysical activity be for at least 30 min, but preferably 45-60 min, at least 5 d/wk (1⎟ ⊕⊕).
ÎA diet with adequate fiber that is low in saturated fat (less than 7% of total calories) and total fat, with less than 200 mg/d of dietary cholesterol (2⎟ ⊕) and low or absent trans fatty acids (1⎟ ⊕).
