Key result
Early and intensive lifestyle interventions, as well as treatment of hyperglycemia, lipid abnormalities, and hypertension, can result in long-term beneficial effects on cardiovascular outcomes, a phenomenon designated as vascular memory.
Why the study?
Do early and intensive lifestyle interventions, antihyperglycaemic, lipid-lowering, and antihypertensive treatments improve long-term cardiovascular outcomes in patients with metabolic and cardiovascular risk factors?
Do early and intensive lifestyle interventions, antihyperglycaemic, lipid-lowering, and antihypertensive treatments improve long-term cardiovascular outcomes in patients with metabolic and cardiovascular risk factors?
The review proposes broadening the concept of metabolic memory to 'vascular memory', highlighting that early and intensive risk factor management yields sustained long-term cardiovascular benefits.
May support early intensive risk factor control for sustained CV benefit; hypothesis-generating for vascular memory and needs prospective trials.
Based on the results of recent randomized, controlled clinical trials and analyses of their follow-up periods the concept of metabolic memory cannot be restricted to antihyperglycaemic treatment only, rather it can be extended to lipid-lowering and antihypertensive treatment and even life-style modification. This broadened concept can be designated as vascular memory. According to this new concept, not only immediate and short-term but long-term effects of the metabolic and cardiovascular risk milieu are of great importance. Consequently, early and intensive lifestyle interventions, treatment of hyperglycaemia, lipid abnormalities and hypertension can result in beneficial effects on cardiovascular outcomes even in the long run. On the contrary, failing in target-oriented treatment from early detection of abnormalities can be associated with life-threatening cardiovascular events subsequently. Additional experimental studies are needed to characterize the exact pathomechanism of vascular memory and further clinical trials are also essential to explore its real clinical significance.
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György Jermendy (2012) conducted a review in Cardiovascular diseases and metabolic disorders. Early intensive treatment of hyperglycemia, dyslipidemia, hypertension, and lifestyle modification vs. Conventional treatment or placebo was evaluated. Early and intensive lifestyle interventions, as well as treatment of hyperglycemia, lipid abnormalities, and hypertension, can result in long-term beneficial effects on cardiovascular outcomes, a phenomenon designated as vascular memory.
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