Biography
Biography: Sameh Salama
Abstract
Cardiovascular disease(CVD) and diabetes are among the leading global and regional causes of death; between 1990 and 2016 CVD deaths increased by 25%.In a recent comparative assessment of the global burden of metabolic risk factors for CVD, 60% of worldwide CVD deaths in year 2010 was attributable to four modifiable cardiometabolic risk factors: high BP, blood glucose, BMI, and serum cholesterol.Heart failure is twice as common in diabetic men and five times as common in diabetic women compared to non-diabetics and mortality rates are about twice that of non-diabetic population.The clinical spectrum of cardiovascular diseases in diabetes involves coronary artery disease, heart failure, serious arrythmias and sudden cardiac death,peripheral vascular disease,cerebrovascular disease and stroke.Higher glucose levels predicts higer CV risk, each 1% increase in HBA1c leads to 15% increase in the risk of heart failure.It is conclusively established that the microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy) are directly related to the severity and duration of hyperglycaemia, as reflected by the HbA1c.However, macrovascular complications are the primary cause of mortality, with myocardial infarction and stroke accounting for 80% of all deaths in diabetic patients.Therefore, when selecting medications to normalize glucose levels in diabetic patients, it is important that the agent should not aggravate, and ideally even improve, cardiovascular risk factors (CVRFs) and reduce cardiovascular morbidity and mortality.In this presentation, we will review the effect of oral glucose-lowering drugs (metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP4 inhibitors, SGLT2 inhibitors, and α-glucosidase inhibitors) on established CVRFs and long-term studies of cardiovascular outcomes.
