Cardiometabolic Medicine: Development of a New Subspecialty

David R. Saxon; Cara Reiter-Brennan; Michael J. Blaha; Robert H. Eckel

Disclosures

J Clin Endocrinol Metab. 2020;105(7):2095-2104. 

In This Article

Abstract and Introduction

Abstract

Context: The worldwide rise in the prevalence of cardiometabolic disease, and the introduction of therapeutic options for treating metabolic disease that also lower cardiovascular risk, calls for a restructuring of how we care for patients with cardiometabolic disease. We propose establishment of a new medicine subspecialty, Cardiometabolic Medicine.

Evidence Acquisition: This summary is based on a synthesis of published original and review articles identified through PubMed, professional society guidelines, and the authors' knowledge of the fields of metabolism, diabetes, and cardiology.

Evidence Synthesis: The growing prevalence of cardiometabolic disease will continue to be perhaps the greatest challenge in the United States and throughout the world. We have entered an era where a large set of clinical tools are available that help prevent and treat cardiometabolic disease; however, our old models of clinical training and siloed care are barriers to rapid uptake and efficient healthcare delivery and are in need of change.

Conclusions: Establishing the field of Cardiometabolic Medicine would be a small step in the right direction towards providing the best possible comprehensive care for those with complex cardiometabolic disease.

Introduction

A worldwide epidemic of metabolic disease exists. In the United States alone, this epidemic has resulted in climbing rates of obesity, metabolic syndrome, and type 2 diabetes (T2DM). While heart disease mortality has declined for many decades, including during the first decade of the 21st century, a deceleration in the decline of all forms of cardiovascular disease (CVD) and associated mortality rates have been noted since 2011.[1] The rise of metabolic disease is likely the major contributor to this trend. While the concept of an overlap between metabolic health issues and CVD dates back to the 1940s,[2] our ability to tackle this complex disease interrelationship through lifestyle and pharmacotherapy has recently entered a new era that requires a reassessment of our traditional models of care and how we educate physicians. In this paper we review recent advancements in the pharmacologic treatment of metabolic disease and propose that out of this clinical complexity rises a critical time to develop a new subspecialty, Cardiometabolic Medicine, with a focus that goes beyond traditional clinical boundaries.

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