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Although the evidence is not conclusive, some data suggest that appropriate treatment of the accompanying depression may decrease cardiovascular risk factors as well.
5 Hence, by controlling the systemic inflammation, TNF inhibitors and methotrexate may decrease cardiovascular risk.
Alternative, potentially reversible, myocardial abnormalities have been sought to provide a target for intervention that may decrease cardiovascular death in this patient population.
They have added benefit in preventing diabetes development and in maintaining glycemic control; may have beneficial β-cell effects, reduce liver fat, and reduce progression of nonalcoholic steatohepatitis; and have pleiotropic that may decrease cardiovascular risk.
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Thus, reduction in HbA1c per se may not decrease cardiovascular complications unless the medications used to treat IGT/IFG correct established cardiovascular risk factors, independent of their glucose-lowering effect.
50 Early data additionally indicates liraglutide treatment may also decrease cardiovascular markers such as PAI-1 and BNP, but the clinical implications, either positive or detrimental, of these findings are unknown.
Recent large clinical trials show that alogliptin [ 15] and saxagliptin [ 16] failed to reduce cardiovascular events in patients with type 2 diabetes, although the meta-analysis provides evidence that compared to other glucose-lowering therapies, DPP-4 inhibitors may possibly decrease cardiovascular events in patients with type 2 diabetes [ 7].
The simple hypothesis that any agent that raises high density lipoprotein levels should decrease cardiovascular events may not be correct.
Nevertheless, reduction of vascular remodeling achieved through NO- dependent and -independent pathways may be an important goal to decrease cardiovascular risk, particularly in high-risk patients, such as those with metabolic syndrome or with clusters of cardiovascular risk factors, as found in patients with hypertension and diabetes.
Whether such interventions could decrease cardiovascular disease in RA may deserve further study.
Three recent trials suggested that aggressive RAAS blockade, that is, combination of 2 RAAS-blocking agents, does not decrease cardiovascular and renal morbidity and may carry an increased risk of serious complications.
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