Type 2 diabetes and chronic systolic heart failure: clinical implications.
Diabetes is a chronic progressive endocrinopathy associated with significant macrovascular and microvascular complications as well as cardiomyopathy and heart failure (HF). Diabetes and chronic systolic HF result in similar activation of pathologic neurohormonal pathways. When diabetes and HF coexist, morbidity and mortality significantly increase. This article reviews important clinical issues in the care of patients with diabetes and HF. A review of pertinent pathophysiologic principles is provided, followed by a discussion of the treatment issues related to this population. Treatment issues include vascular disease risk factor modification, HF pharmacotherapy, glycemic management, and control of other common comorbid conditions.
Langford
Mary C
MC
Cardiology, Kaiser Permanente, Heart Failure Treatment Program, Fairfax, VA, USA. mary.c.langford@kp.org
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002908:Chronic Disease; D048909:Diabetes Complications / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy*; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D009017:Morbidity; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013599:Systole
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents; D004232:Diuretics; D007004:Hypoglycemic Agents; D000451:Mineralocorticoid Receptor Antagonists