Physicians are strongly advised to assess patients for their global risk of cardiovascular disease and diabetes, according to a “call to action” from the American Heart Association and the American Diabetes Association.
“The overweight or obese patient deserves major clinical attention. The growing prevalence of this condition threatens to undermine all of our recent gains to prevent and control chronic disease,” the authors wrote (Circulation 2006;113:2943–6, Diabetes Care DOI: 10.2337/dc06-9911).
Cowritten by the presidents and chief science advisors of the two organizations, the document was issued in part to dispel the notion that there is disagreement between the ADA and AHA about the need to assess patients for risk factors such as prediabetes, hypertension, dyslipidemia, obesity, and smoking. In fact, the debate has been specifically about the clinical utility of the term “metabolic syndrome,” not about the overall need to screen patients for risk of cardiovascular disease (CVD), they said.
“Unfortunately, some of the medical press have positioned the scientific issues related to the metabolic syndrome as a 'battle' between the [ADA and AHA], implicitly suggesting that CVD risk factor identification and treatment is now questionable. We are concerned that the presumed dispute will lead to a reduction in the favorable trend of many aspects of CVD risk factor reduction,” said AHA president Dr. Robert H. Eckel and ADA president Dr. Robert Rizza, along with science advisors Richard Kahn, Ph.D., of the ADA and Dr. Rose Marie Robertson of the AHA.
Another reason for issuing the statement, they noted, is the recent evidence suggesting that risk assessment and adherence to national guidelines remains “woefully suboptimal.”
The ADA has an online tool, at www.diabetes.org/diabetesphd