Reducing cardiovascular disease in patients with diabetes mellitus.
OBJECTIVE
Patients with diabetes may be considered high-risk for management of cardiovascular risk factors not only because of increased rates of myocardial infarction but also because of a high prevalence of significant subclinical coronary artery disease and a poorer prognosis after myocardial infarction.


RESULTS
Appropriate management of hypertension and hyperlipidemia has been shown unequivocally to reduce cardiovascular events. Benefit has been demonstrated with multiple antihypertensive agents; however, some studies suggest an advantage for angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Most data for management of lipid disorders in diabetes have been obtained using statins; the value of combination lipid-lowering therapy remains to be validated.


CONCLUSIONS
The role of glucose control in managing cardiovascular risk in patients with diabetes remains unclear. Epidemiologic studies suggest a strong relation between markers of glycemia and cardiovascular risk, even extending into the nondiabetic spectrum. Ongoing trials are evaluating novel strategies for reducing cardiovascular events in patients with diabetes.
Mazzone
Theodore
T
Section of Diabetes and Metabolism, University of Illinois at Chicago, Chicago, IL 60612, USA. tmazzone@uic.edu
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D048909:Diabetes Complications / Q000517:prevention & control*; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control; D006973:Hypertension / Q000517:prevention & control
D000959:Antihypertensive Agents