Type 2 diabetes: one disease, multiple cardiovascular risk factors.
Type 2 diabetes mellitus is a major independent risk factor for coronary artery disease. Atherosclerosis accounts for about 80% of all deaths from type 2 diabetes, of which roughly 75% are attributable to coronary artery disease and the remainder to cerebrovascular or peripheral vascular events [1]. The earlier onset and accelerated course of atherosclerosis in individuals with type 2 diabetes mellitus is multifactorial. Type 2 diabetes is associated with abnormalities in lipoprotein metabolism and increased propensity for oxidative damage. The hyperglycemia of patients with type 2 diabetes, in itself, may accelerate vascular damage. Type 2 diabetes is a hypercoagulable state attributable to enhanced coagulation and decreased fibrinolysis, as well as platelet hyperaggregability and endothelial dysfunction. Hypertension is common in individuals with type 2 diabetes and has a major impact in the accelerated atherosclerosis of this disease. This review provides an overview of selected aspects of these alterations.
Calles-Escandon
J
J
Department of Internal Medicine, University of Vermont, Burlington 05401, USA. jcallese@zoo.uvm.edu
Garcia-Rubi
E
E
Mirza
S
S
Mortensen
A
A
D001161:Arteriosclerosis / Q000453:epidemiology; D001777:Blood Coagulation; D003324:Coronary Artery Disease / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D012307:Risk Factors