Cardiometabolic risk management: insights from a European Society of Cardiology Cardiovascular Round Table

Francesco Cosentino; Subodh Verma; Philip Ambery; Marianne Bach Treppendahl; Martin Van Eickels; Stefan D. Anker; Michele Cecchini; Paola Fioretto; Per Henrik Groop; David Hess; Kamlesh Khunti; Carolyn S.P. Lam; Isabelle Richard-Lordereau; Lars H. Lund; Paul Mcgreavy; Philip N. Newsome; Naveed Sattar; Scott Solomon; Franz Weidinger; Faiez Zannad; Andreas Zeiher

doi:10.1093/eurheartj/ehad445

Cardiometabolic risk management: insights from a European Society of Cardiology Cardiovascular Round Table

Francesco Cosentino^*, Subodh Verma, Philip Ambery, Marianne Bach Treppendahl, Martin Van Eickels, Stefan D. Anker, Michele Cecchini, Paola Fioretto, Per Henrik Groop, David Hess, Kamlesh Khunti, Carolyn S.P. Lam, Isabelle Richard-Lordereau, Lars H. Lund, Paul Mcgreavy, Philip N. Newsome, Naveed Sattar, Scott Solomon, Franz Weidinger, Faiez ZannadAndreas Zeiher

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

Abstract

Metabolic comorbidities are common in patients with cardiorenal disease; they can cause atherosclerotic cardiovascular disease (ASCVD), speed progression, and adversely affect prognosis. Common comorbidities are Type 2 diabetes mellitus (T2DM), obesity/overweight, chronic kidney disease (CKD), and chronic liver disease. The cardiovascular system, kidneys, and liver are linked to many of the same risk factors (e.g. dyslipidaemia, hypertension, tobacco use, diabetes, and central/truncal obesity), and shared metabolic and functional abnormalities lead to damage throughout these organs via overlapping pathophysiological pathways. The COVID-19 pandemic has further complicated the management of cardiometabolic diseases. Obesity, T2DM, CKD, and liver disease are associated with increased risk of poor outcomes of COVID-19 infection, and conversely, COVID-19 can lead to worsening of pre-existing ASCVD. The high rates of these comorbidities highlight the need to improve recognition and treatment of ASCVD in patients with obesity, insulin resistance or T2DM, chronic liver diseases, and CKD and equally, to improve recognition and treatment of these diseases in patients with ASCVD. Strategies to prevent and manage cardiometabolic diseases include lifestyle modification, pharmacotherapy, and surgery. There is a need for more programmes at the societal level to encourage a healthy diet and physical activity. Many pharmacotherapies offer mechanism-based approaches that can target multiple pathophysiological pathways across diseases. These include sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, selective mineralocorticoid receptor antagonists, and combined glucose-dependent insulinotropic peptide/glucagon-like peptide-1 receptor agonist. Non-surgical and surgical weight loss strategies can improve cardiometabolic disorders in individuals living with obesity. New biomarkers under investigation may help in the early identification of individuals at risk and reveal new treatment targets.

Original language	English
Pages (from-to)	4141-4156
Number of pages	16
Journal	European Heart Journal
Volume	44
Issue number	39
Early online date	14 Jul 2023
DOIs	https://doi.org/10.1093/eurheartj/ehad445
Publication status	Published - 14 Oct 2023

Bibliographical note

Funding Information:
This article was generated from discussions during a virtual Cardiovascular Round Table (CRT) workshop organized in May 2022 by the European Society of Cardiology (ESC). The ESC CRT is a strategic forum for high-level dialogue between 20 industry companies (pharmaceutical, devices, and diagnostics) and the ESC leadership to identify and discuss key strategic issues for the future of cardiovascular health in Europe. The authors alone are responsible for the views expressed in this manuscript, which do not necessarily represent the views or policies of the institution to which the authors are affiliated. The authors would like to thank Pauline Lavigne and Steven Portelance (unaffiliated, supported by the ESC) for contributions to writing and editing the manuscript.

Publisher Copyright:
© 2023 The Author(s).

Keywords

Atherosclerotic cardiovascular disease
Bariatric surgery
Cardiometabolic risk factors
Chronic kidney disease
Chronic liver diseases
COVID-19
Glucagon-like peptide-1 receptor agonists
Obesity
Sodium glucose cotransporter-2 inhibitors
Type 2 diabetes mellitus

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/eurheartj/ehad445Licence: None: All rights reserved

Cite this

Cosentino, F., Verma, S., Ambery, P., Treppendahl, M. B., Van Eickels, M., Anker, S. D., Cecchini, M., Fioretto, P., Groop, P. H., Hess, D., Khunti, K., Lam, C. S. P., Richard-Lordereau, I., Lund, L. H., Mcgreavy, P., Newsome, P. N., Sattar, N., Solomon, S., Weidinger, F., ... Zeiher, A. (2023). Cardiometabolic risk management: insights from a European Society of Cardiology Cardiovascular Round Table. European Heart Journal, 44(39), 4141-4156. https://doi.org/10.1093/eurheartj/ehad445

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abstract = "Metabolic comorbidities are common in patients with cardiorenal disease; they can cause atherosclerotic cardiovascular disease (ASCVD), speed progression, and adversely affect prognosis. Common comorbidities are Type 2 diabetes mellitus (T2DM), obesity/overweight, chronic kidney disease (CKD), and chronic liver disease. The cardiovascular system, kidneys, and liver are linked to many of the same risk factors (e.g. dyslipidaemia, hypertension, tobacco use, diabetes, and central/truncal obesity), and shared metabolic and functional abnormalities lead to damage throughout these organs via overlapping pathophysiological pathways. The COVID-19 pandemic has further complicated the management of cardiometabolic diseases. Obesity, T2DM, CKD, and liver disease are associated with increased risk of poor outcomes of COVID-19 infection, and conversely, COVID-19 can lead to worsening of pre-existing ASCVD. The high rates of these comorbidities highlight the need to improve recognition and treatment of ASCVD in patients with obesity, insulin resistance or T2DM, chronic liver diseases, and CKD and equally, to improve recognition and treatment of these diseases in patients with ASCVD. Strategies to prevent and manage cardiometabolic diseases include lifestyle modification, pharmacotherapy, and surgery. There is a need for more programmes at the societal level to encourage a healthy diet and physical activity. Many pharmacotherapies offer mechanism-based approaches that can target multiple pathophysiological pathways across diseases. These include sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, selective mineralocorticoid receptor antagonists, and combined glucose-dependent insulinotropic peptide/glucagon-like peptide-1 receptor agonist. Non-surgical and surgical weight loss strategies can improve cardiometabolic disorders in individuals living with obesity. New biomarkers under investigation may help in the early identification of individuals at risk and reveal new treatment targets.",

keywords = "Atherosclerotic cardiovascular disease, Bariatric surgery, Cardiometabolic risk factors, Chronic kidney disease, Chronic liver diseases, COVID-19, Glucagon-like peptide-1 receptor agonists, Obesity, Sodium glucose cotransporter-2 inhibitors, Type 2 diabetes mellitus",

author = "Francesco Cosentino and Subodh Verma and Philip Ambery and Treppendahl, {Marianne Bach} and {Van Eickels}, Martin and Anker, {Stefan D.} and Michele Cecchini and Paola Fioretto and Groop, {Per Henrik} and David Hess and Kamlesh Khunti and Lam, {Carolyn S.P.} and Isabelle Richard-Lordereau and Lund, {Lars H.} and Paul Mcgreavy and Newsome, {Philip N.} and Naveed Sattar and Scott Solomon and Franz Weidinger and Faiez Zannad and Andreas Zeiher",

note = "Funding Information: This article was generated from discussions during a virtual Cardiovascular Round Table (CRT) workshop organized in May 2022 by the European Society of Cardiology (ESC). The ESC CRT is a strategic forum for high-level dialogue between 20 industry companies (pharmaceutical, devices, and diagnostics) and the ESC leadership to identify and discuss key strategic issues for the future of cardiovascular health in Europe. The authors alone are responsible for the views expressed in this manuscript, which do not necessarily represent the views or policies of the institution to which the authors are affiliated. The authors would like to thank Pauline Lavigne and Steven Portelance (unaffiliated, supported by the ESC) for contributions to writing and editing the manuscript. Publisher Copyright: {\textcopyright} 2023 The Author(s).",

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Cosentino, F, Verma, S, Ambery, P, Treppendahl, MB, Van Eickels, M, Anker, SD, Cecchini, M, Fioretto, P, Groop, PH, Hess, D, Khunti, K, Lam, CSP, Richard-Lordereau, I, Lund, LH, Mcgreavy, P, Newsome, PN, Sattar, N, Solomon, S, Weidinger, F, Zannad, F & Zeiher, A 2023, 'Cardiometabolic risk management: insights from a European Society of Cardiology Cardiovascular Round Table', European Heart Journal, vol. 44, no. 39, pp. 4141-4156. https://doi.org/10.1093/eurheartj/ehad445

TY - JOUR

T1 - Cardiometabolic risk management

T2 - insights from a European Society of Cardiology Cardiovascular Round Table

AU - Cosentino, Francesco

AU - Verma, Subodh

AU - Ambery, Philip

AU - Treppendahl, Marianne Bach

AU - Van Eickels, Martin

AU - Anker, Stefan D.

AU - Cecchini, Michele

AU - Fioretto, Paola

AU - Groop, Per Henrik

AU - Hess, David

AU - Khunti, Kamlesh

AU - Lam, Carolyn S.P.

AU - Richard-Lordereau, Isabelle

AU - Lund, Lars H.

AU - Mcgreavy, Paul

AU - Newsome, Philip N.

AU - Sattar, Naveed

AU - Solomon, Scott

AU - Weidinger, Franz

AU - Zannad, Faiez

AU - Zeiher, Andreas

N1 - Funding Information: This article was generated from discussions during a virtual Cardiovascular Round Table (CRT) workshop organized in May 2022 by the European Society of Cardiology (ESC). The ESC CRT is a strategic forum for high-level dialogue between 20 industry companies (pharmaceutical, devices, and diagnostics) and the ESC leadership to identify and discuss key strategic issues for the future of cardiovascular health in Europe. The authors alone are responsible for the views expressed in this manuscript, which do not necessarily represent the views or policies of the institution to which the authors are affiliated. The authors would like to thank Pauline Lavigne and Steven Portelance (unaffiliated, supported by the ESC) for contributions to writing and editing the manuscript. Publisher Copyright: © 2023 The Author(s).

PY - 2023/10/14

Y1 - 2023/10/14

N2 - Metabolic comorbidities are common in patients with cardiorenal disease; they can cause atherosclerotic cardiovascular disease (ASCVD), speed progression, and adversely affect prognosis. Common comorbidities are Type 2 diabetes mellitus (T2DM), obesity/overweight, chronic kidney disease (CKD), and chronic liver disease. The cardiovascular system, kidneys, and liver are linked to many of the same risk factors (e.g. dyslipidaemia, hypertension, tobacco use, diabetes, and central/truncal obesity), and shared metabolic and functional abnormalities lead to damage throughout these organs via overlapping pathophysiological pathways. The COVID-19 pandemic has further complicated the management of cardiometabolic diseases. Obesity, T2DM, CKD, and liver disease are associated with increased risk of poor outcomes of COVID-19 infection, and conversely, COVID-19 can lead to worsening of pre-existing ASCVD. The high rates of these comorbidities highlight the need to improve recognition and treatment of ASCVD in patients with obesity, insulin resistance or T2DM, chronic liver diseases, and CKD and equally, to improve recognition and treatment of these diseases in patients with ASCVD. Strategies to prevent and manage cardiometabolic diseases include lifestyle modification, pharmacotherapy, and surgery. There is a need for more programmes at the societal level to encourage a healthy diet and physical activity. Many pharmacotherapies offer mechanism-based approaches that can target multiple pathophysiological pathways across diseases. These include sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, selective mineralocorticoid receptor antagonists, and combined glucose-dependent insulinotropic peptide/glucagon-like peptide-1 receptor agonist. Non-surgical and surgical weight loss strategies can improve cardiometabolic disorders in individuals living with obesity. New biomarkers under investigation may help in the early identification of individuals at risk and reveal new treatment targets.

AB - Metabolic comorbidities are common in patients with cardiorenal disease; they can cause atherosclerotic cardiovascular disease (ASCVD), speed progression, and adversely affect prognosis. Common comorbidities are Type 2 diabetes mellitus (T2DM), obesity/overweight, chronic kidney disease (CKD), and chronic liver disease. The cardiovascular system, kidneys, and liver are linked to many of the same risk factors (e.g. dyslipidaemia, hypertension, tobacco use, diabetes, and central/truncal obesity), and shared metabolic and functional abnormalities lead to damage throughout these organs via overlapping pathophysiological pathways. The COVID-19 pandemic has further complicated the management of cardiometabolic diseases. Obesity, T2DM, CKD, and liver disease are associated with increased risk of poor outcomes of COVID-19 infection, and conversely, COVID-19 can lead to worsening of pre-existing ASCVD. The high rates of these comorbidities highlight the need to improve recognition and treatment of ASCVD in patients with obesity, insulin resistance or T2DM, chronic liver diseases, and CKD and equally, to improve recognition and treatment of these diseases in patients with ASCVD. Strategies to prevent and manage cardiometabolic diseases include lifestyle modification, pharmacotherapy, and surgery. There is a need for more programmes at the societal level to encourage a healthy diet and physical activity. Many pharmacotherapies offer mechanism-based approaches that can target multiple pathophysiological pathways across diseases. These include sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, selective mineralocorticoid receptor antagonists, and combined glucose-dependent insulinotropic peptide/glucagon-like peptide-1 receptor agonist. Non-surgical and surgical weight loss strategies can improve cardiometabolic disorders in individuals living with obesity. New biomarkers under investigation may help in the early identification of individuals at risk and reveal new treatment targets.

KW - Atherosclerotic cardiovascular disease

KW - Bariatric surgery

KW - Cardiometabolic risk factors

KW - Chronic kidney disease

KW - Chronic liver diseases

KW - COVID-19

KW - Glucagon-like peptide-1 receptor agonists

KW - Obesity

KW - Sodium glucose cotransporter-2 inhibitors

KW - Type 2 diabetes mellitus

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DO - 10.1093/eurheartj/ehad445

M3 - Review article

C2 - 37448181

AN - SCOPUS:85174921095

SN - 0195-668X

VL - 44

SP - 4141

EP - 4156

JO - European Heart Journal

JF - European Heart Journal

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ER -

Cardiometabolic risk management: insights from a European Society of Cardiology Cardiovascular Round Table

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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Cite this