Cardiovascular Prevention and Pharmacotherapy

Review Articles

Managing hypertension, diabetes, and dyslipidemia in frail older adults: Jung-Yeon Choi, Cheol-Ho Kim, Kwang-il Kim; Cardiovasc Prev Pharmacother. 2025;7(4):135-140. Published online October 22, 2025; DOI: https://doi.org/10.36011/cpp.2025.7.e16

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Abstract PDF: As the population ages, the prevalence of chronic conditions, such as hypertension, type 2 diabetes, and dyslipidemia, is rapidly increasing, particularly among frail older adults. These conditions share common pathophysiological mechanisms and substantially contribute to the development of atherosclerotic cardiovascular disease. Effective management is essential for reducing cardiovascular risk; however, older adults present unique challenges, including multimorbidity, polypharmacy, cognitive decline, and functional impairment. Frailty further complicates clinical decision-making and necessitates individualized treatment strategies. This review examines current evidence and clinical guidelines for managing hypertension, diabetes, and dyslipidemia in older adults, with a focus on frailty status. It highlights the importance of assessing functional capacity and life expectancy and prioritizing treatments with favorable risk–benefit profiles. Specific recommendations are discussed according to frailty status, including when to initiate or deintensify therapy. Ultimately, a person-centered, geriatric-informed approach is critical to optimize outcomes and preserve quality of life in this vulnerable population.

Lipid variability in patients with diabetes mellitus: Jeongmin Lee, Seung-Hwan Lee; Cardiovasc Prev Pharmacother. 2023;5(4):126-133. Published online October 25, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e18

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Diabetic dyslipidemia is characterized by hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), elevated low-density lipoprotein cholesterol (LDL-C), and the predominance of small dense LDL particles caused by insulin resistance in patients with type 2 diabetes mellitus (DM) or insulin deficiency in patients with type 1 DM. Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease in individuals with DM, and lowering lipid levels can reduce the associated morbidity and mortality. The current guidelines for dyslipidemia management recommend an LDL-C goal lower than 55 to 100 mg/dL, depending on the underlying risk factors. However, greater visit-to-visit variability in cholesterol levels might be an independent predictor of major adverse cardiovascular events, high incidence of atrial fibrillation, poor renal outcomes, and cognitive dysfunction in patients with DM. This review focuses on the clinical implications of lipid variability in patients with DM.

Citations

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Visit-to-visit lipid variability and adverse kidney events in real-world type 2 diabetes patients
Hsuan-Yu Su, Yi-Hsin Chang, Chen-Yi Yang, Wei-Hung Lin, Huang-Tz Ou
Diabetes Research and Clinical Practice.2025; 222: 112093. CrossRef
Antidiabetic and Toxicological Evaluation of Ehretia asperula Leaf Extract in Diabetic Mice
Yen D. H. Nguyen, Tran Chi Linh, Nguyen Trong Tuan, Luu Thai Danh, Dai Thi Xuan Trang
Chemistry & Biodiversity.2025;[Epub] CrossRef
The use of statins in patients with type 2 diabetes mellitus
Vera Morari, Carolina Andriuta, Elena Babalau, Mariana Malevan, Natalia Porcereanu
Public Health, Economy and Management in Medicine.2024; (5(102)): 59. CrossRef

Original Article

Effect of the addition of thiazolidinedione to sodium-glucose cotransporter 2 inhibitor therapy on lipid levels in type 2 diabetes mellitus: a retrospective study using Korean National Health Insurance Service data: Taegyun Park, Kyungdo Han, Dongwook Shin, Jongho Park; Cardiovasc Prev Pharmacother. 2022;4(3):114-122. Published online July 29, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e15

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Abstract PDF

Background
Dyslipidemia is common in patients with type 2 diabetes mellitus (T2D) and contributes to an increased risk of cardiovascular disease. Previous studies have shown that treatment with thiazolidinediones (TZDs) and sodium-glucose cotransporter-2 inhibitors (SGLT2-i) may help to improve dyslipidemia in T2D patients. In this study, we investigated whether patients treated with TZD and SGLT2-i showed greater improvement in high-density lipoprotein cholesterol (HDL-C) levels than those treated with only SGLT2-i.
Methods
From the National Health Insurance Service database of Korea, we extracted all patients who first received SGTL2-i from 2014 to 2016. Propensity score matching was performed to balance the two groups: group A (SGTL2-i and TZD, regardless of other antidiabetic medications) and group B (SGTL2-i only without TZD, regardless of other antidiabetic medications). Posttreatment HDL-C levels were compared by the Student t-test.
Results
In total, 1,400 T2D patients (700 in each group) were matched by propensity score matching. There was a significant posttreatment increase in HDL-C in group A (49.54±20.03 to 51.6±12.92 mg/dL, P=0.007), but not in group B (49.14±13.52 to 49.1±2.15 mg/dL, P=0.937). Group A also showed significantly higher posttreatment HDL-C levels than group B (51.4±12.92 vs. 49.1±12.15 mg/dL, P<0.001). Regarding the secondary endpoints, posttreatment triglyceride levels were lower (P<0.001), but total cholesterol (P=0.131) and low-density lipoprotein cholesterol levels (P=0.054) were not different after treatment.
Conclusions
The combination of SGTL2-i and TZD may be more effective in ameliorating dyslipidemia in T2D patients than SGLT2-i alone. However, further studies are needed to confirm this finding.

Citations

Citations to this article as recorded by

SGLT2 Inhibitor Use and Risk of Dementia and Parkinson Disease Among Patients With Type 2 Diabetes
Hae Kyung Kim, Geert Jan Biessels, Min Heui Yu, Namki Hong, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Eun Jig Lee, Minyoung Lee
Neurology.2024;[Epub] CrossRef
A Green Approach: Optimization of the UPLC Method Using DoE Software for Concurrent Quantification of Pioglitazone and Dapagliflozin in a SNEDDS Formulation for the Treatment of Diabetes
Ehab M. Elzayat, Abdelrahman Y. Sherif, Mohamed W. Attwa, Mohammad A. Altamimi
ACS Omega.2024; 9(45): 45011. CrossRef

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