Diabetic Retinopathy and Cardiovascular Disease. Группа авторов

blood pressure, lipids and use of anti-platelet agents. However, there is controversy surrounding how best to approach risk prediction and primary prevention therapy in patients with diabetes. Some guidelines recommend that the degree of risk inferred by diabetes itself is sufficient to warrant pharmacotherapy targeting tight control of cardiovascular risk factors such as hypertension and dyslipidaemia in most patients. Increasingly, the assessment of absolute cardiovascular risk is being incorporated into clinical care and decision making around the risk modifying therapy.

      Numerous risk scores have been developed and they give an estimate of absolute cardiovascular risk. The evidence base for using these scores in patients with diabetes is not as strong as in the general population and there are few trials investigating their clinical efficacy. The addition of novel biomarkers and genetic risk scores to cardiovascular risk prediction models may strengthen statistical associations but at this stage have not been shown to substantially alter clinical practice among diabetes patients. Understanding risk at the individual level has the potential to guide decisions regarding use of lipid-lowering agents, antihypertensives and antiplatelet agents. It may also help guide choice of antihyperglycaemic therapy in light of growing evidence regarding the cardiovascular benefits and possible risks of some agents. Knowledge of individual-level risk can also be used to educate and motivate patients.

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