Several studies suggest that the cardiovascular disease (CVD) mortality rates of persons with type 2 diabetes are about two to four times higher than those of the general population. It is therefore considered necessary to develop specific tools to evaluate and reduce CVD risk in this population. In the present chapter, main CVD risk scores were explored: from the Framingham study developed in the 1960s to the last diabetes-specific models, passing through the concept of diabetes as a “CVD risk equivalent”. The scores developed in Italian population were specifically explored. The Italian experience, according to other countries, emphasizes that it may be appropriate for each country to validate existing models and eventually to adapt them to the different settings to improve targeted risk management.
Part of the book: Primary Care in Practice
Chronic heart failure (CHF or simply HF) is a complex clinical syndrome that involves more than 2% of the general population and over 10% of the older people. For people with reduced ventricular function (the classical HFrEF phenotype), the guideline-directed medical therapy (GDMT) (e.g., Ace-inhibitors, beta-blockers, diuretics, rehabilitation or implantable ventricular devices) demonstrated to be efficacious in reducing hospitalisations and prolonging survival. Vice-versa, the HF with preserved ejection fraction (diastolic HF or HFpEF phenotype) is a much more complex syndrome, in which co-morbidities (such as COPD, depression, anemia, and diabetes, CAD) play a significant role in the decompensation episodes.
Part of the book: Primary Care in Practice