Reducing Cardiovascular Risk In Diabetes

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GREETINGS --

The following is an excerpt from an article regarding cardiovascular

risk in diabetics. The article is from the Postgraduate Medicine

Journal and can be found at

www.postgredmed.com/issues/2001/04/_01/spanheimer.htm.

wambo1941

Reducing cardiovascular risk in diabetes

Which factors to modify first?

G. Spanheimer, MD

VOL 109 / NO 4 / APRIL 2001 / POSTGRADUATE MEDICINE

Diabetic patients are at high risk for morbidity and mortality from

vascular complications. Therefore, it is important to identify and

modify cardiovascular risk factors early in these patients. In this

article, Dr Spanheimer discusses the major risk factors as well as

other atherogenic factors and presents a practical approach for

achieving recommended treatment goals.

Cardiovascular complications (eg, coronary artery disease [CAD],

stroke, peripheral vascular disease, cardiomyopathy, congestive heart

failure) are the leading cause of morbidity and mortality related to

diabetes mellitus. Complications of atherosclerosis are responsible

for about 80% of deaths in diabetic patients and 75% of

hospitalizations for diabetic complications. In a 7-year study

conducted in Finland (1), the absolute risk for major cardiac events

in patients who had type 2 diabetes without known CAD was 20.2%

compared with 18.8% in matched nondiabetic patients who had

established CAD. Even before the development of hyperglycemia,

persons with impaired glucose tolerance have an elevated risk of

macrovascular disease (see box below). Fifty percent of patients have

evidence of cardiovascular disease at the time of diagnosis of type 2

diabetes.

Although mortality due to cardiovascular disease has continued to

decline in nondiabetic populations in the past 25 years, it has

remained steady or has increased in the diabetic population. Persons

with diabetes also have a higher risk of death before and after

infarction as well as an increased incidence of congestive heart

failure. As the number of diabetic patients increases, so too does

the impact on public health.