- New Endocrine Society clinical practice guidelines address primary prevention of atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes (T2D) in individuals at risk.
- Cosponsored by the American Diabetes Association and the European Society of Endocrinology.
- Regularly screen and identify individuals age 40-75 years at metabolic risk for ASCVD and T2D by measuring BP, waist circumference, fasting lipid profile, and blood glucose.
- In those at risk, apply a 10-year global risk assessment for ASCVD or coronary heart disease to determine therapy targets for reducing apolipoprotein B-containing lipoproteins.
- Hypertension should be treated to guideline targets.
- Individuals identified with prediabetes should be tested at least annually for progression to T2D and referred to intensive behavioral counseling programs.
- Lifestyle management should be the first priority for primary prevention of ASCVD and T2D.
- Behavioral programs should include heart-healthy dietary pattern, sodium restriction, daily walking, limited sedentary time, and structured physical activity program.
- Those with overweight/obesity should aim for ≥5% reduction in initial body weight in the first year.
- Behavior changes should be supported by a comprehensive program led by trained interventionists and reinforced by clinicians.
- Pharmacological therapy can be added to lifestyle modification if recommended goals are not achieved.