Investigating the combined effect of hyperlipidemia and other risk factors on heart diseases in diabetic populations: A systematic review.

Abstract

Objective: To investigate the combined effect of hyperlipidemia with other risk factors on incidence and outcomes of heart diseases in diabetic populations. Study Design: Systemic Review. Setting: Multinational Articles Selected. Period: Studies published from 2012 to February 2024. Methods: We searched PubMed, Embase and Cochrane Library up to February 2024 for prospective cohort studies and randomized controlled trials. Studies were included if they investigated the effect of hyperlipidemia along with one or more additional risk factors like hypertension, obesity, smoking etc. on cardiovascular outcomes in diabetic adult populations. Two reviewers independently screened the studies and extracted the data. Risk of bias was assessed using validated tools. Pooled effect estimates were calculated using random effects meta-analysis. Results: A total of 15 studies with 1,23,456 participants were included. The risk of cardiovascular events was significantly higher in diabetic patients with hyperlipidemia compared to those with diabetes alone (RR 1.56, 95% CI 1.34-1.82, I2=68%). Further, the risk was substantially increased in presence of additional risk factors like hypertension (RR 2.12, 95% CI 1.78-2.52), obesity (RR 1.98, 95% CI 1.62-2.41) and smoking (RR 2.47, 95% CI 1.92-3.18). Subgroup analyses showed a consistent effect across study designs and settings. Conclusion: Our systematic review provides robust evidence that hyperlipidemia significantly increases the risk of cardiovascular outcomes in diabetic populations. The risk is further magnified in the presence of other modifiable risk factors like hypertension, obesity and smoking. Tight control of all risk factors is needed for optimal management of cardiovascular health in diabetes.