[Cardiovascular prevention according to CEIPC: a critical appraisal].

We present a critical appraisal of the adaptation to the 4th European Guidelines on Cardiovascular Disease Prevention in Clinical Practice carried out by The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention (CEIPC), which is based on: 1) the removal, by the CEIPC, of important restrictions on the start of drug therapy that are contained in the European guide 2) the existence of internal contradictions and differing recommendations regarding the goals of LDL in the several publications of the CEIP adaptation; and 3) and the almost total lack of necessary discussion about risk tables in Spain. Therefore, it makes a critical appraisal of some of the most important clinical recommendations shared by the CEIPC and the European guide that are not supported by clinical evidence, like the implicit proposal of using the estimated cardiovascular risk as a target for treatment, the criteria to begin the antihypertensive drug therapy and therapeutic goals for blood pressure, LDL-cholesterol and HbA1c. The public health administration and also the scientific society must ensure transparency and independence in the drafting of documents endorsed by them, including the management and declaration of potential conflicts of interest among editors and group members.

[Blood pressure goals in diabetes. A critical appraisal].

In this article we review the evidence supporting the need to achieve a target blood pressure (BP) under 130-80 mm Hg in diabetic patients, as recent international guidelines recommend (JNC VII, ESH-ESC and ADA). We have analyzed the explicit arguments used in these guidelines, 3 clinical trials designed to determine which is the best BP in diabetics (HOT, UKPDS-38 and ABCD) as well as other potentially misleading clinical trials. In our opinion, neither these 3 specific clinical trials nor other trials quoted in the guidelines (due to results and methodology employed) can answer the question of the best goal of pharmacological treatment for hypertension in diabetics.