Older people need regular tests for diabetes, heart disease

In a new guideline, researchers suggest that older people should have regular health checks for diabetes and heart disease.

The tests include measuring waistline, blood pressure, cholesterol, blood fats, and blood sugar.

The Clinical Practice Guideline was issued by the Endocrine Society.

The five risk factors for heart disease and diabetes are – a large amount of abdominal body fat, low HDL (“good”) cholesterol, high levels of fat in the blood known as triglycerides, high blood pressure, and high blood sugar.

Patients with at least three of these factors are at metabolic risk (higher risk for heart disease and diabetes).

The current guideline recommends checking patients with three or more risk factors regularly and screening patients with one or two risk factors every three years.

This is in addition to checking risk factors for heart disease like “bad” cholesterol, smoking and family history.

The new guideline takes a fresh look at metabolic risk and the recommendations reflect more recent trial data on blood pressure and lipids.

The guideline highlights the lifestyle and behavioral interventions and discusses new medical treatment options.

It focuses on adults aged 40 to 75 but can be used to guide patients outside of this age range as well.

Researchers say that doctors haven’t been doing enough to measure waist circumference, but it’s essential to identifying patients at metabolic risk earlier and preventing more cases of heart disease and diabetes.

They emphasize the importance of lifestyle, dietary and behavioral changes as the first-line treatment.

However, treatment with medication is appropriate if goals are not met with lifestyle changes alone.

Recommendations from the guideline include:

Measuring waist circumference as a routine part of the clinical examination.

Checking blood pressure annually, and, if elevated, at each subsequent visit.

Highlighting lifestyle modification as first-line therapy.

Aiming to lose 5% or more of initial body weight over the first year for individuals at metabolic risk with excess weight.

Undergoing a 10-year global risk assessment for either coronary heart disease or atherosclerotic cardiovascular disease to guide the use of medical or pharmacological therapy.

Prescribing lifestyle modification before drug therapy in patients with pre-diabetes to reduce blood sugar levels.

One author of the study is James L. Rosenzweig, M.D., of Hebrew Rehabilitation Hospital in Boston, Mass. Rosenzweig chaired the writing committee that developed the guideline.

The study is published in The Journal of Clinical Endocrinology & Metabolism (JCEM).

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