[Type 2 diabetes and cardiovascular risk: lessons from therapeutic trials].
Cardiovascular risk reduction in diabetic patients is a multidimensional task. Long-term decrease of glycaemia by the use of insulin or sulfonylureas had disappointing effects on cardiovascular events, whereas metformin effects are ambiguous. On the contrary, controlling risk factors like hypertension or hypercholesterolaemia decrease the incidence of cardiovascular events in diabetic as in non-diabetic patients. Similarly, clinical trials have shown the efficacy of treatments that decrease cardiovascular risk whatever the cause, such as antiplatelet drugs in secondary prevention and high-dose ramipril in secondary prevention or in hypertensive patients. The absolute benefit conferred by efficient therapies is higher in diabetic patients because they are at an increased risk of events compared with their non-diabetic counterparts.
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Service de pharmacologie clinique Faculté de médecine Laennec 69376 Lyon. ml@upcl.univ-lyon1.fr
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D015201:Meta-Analysis as Topic; D009765:Obesity / Q000150:complications; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011322:Primary Prevention; D011446:Prospective Studies; D017257:Ramipril / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D001786:Blood Glucose; D010975:Platelet Aggregation Inhibitors; D002784:Cholesterol; D017257:Ramipril