[Type 2 diabetes mellitus and cardiovascular risk factors: is comprehensive treatment required?].
Diabetes mellitus, especially type 2, is a metabolic disease involving the coexistence of several cardiovascular risk factors. Affected patients are therefore at high cardiovascular risk (2-3 times higher than that of men in the general population and 2-6 times higher than that of women). Cardiovascular disease is the main cause of death in the diabetic population, followed by cancer. Cardiovascular risk cannot be compared between diabetic patients and persons who have already shown one or more manifestations of cardiovascular disease (such as myocardial infarction). Single risk factors should be evaluated in combination with other risk factors and a person's cardiovascular risk should be individually assessed. Cardiovascular risk assessment in patients with diabetes through current calculations methods is complex because their ability to predict risk in individuals is very low. Studies such as that by Steno have demonstrated the validity of a comprehensive strategy to control all the risk factors present in persons with type 2 diabetes mellitus, which can reduce the development of micro- and macrovascular complications and mortality by almost 50%. The present article reviews each of the classical cardiovascular risk factors (hypertension, dyslipidemia, smoking, obesity, sedentariness) in relation to diabetes, as well as their recommended targets and the benefits of their control. In view of the above, a comprehensive approach is recommended to control the multiple risk factors that can coexist in persons with type 2 diabetes mellitus.
EAP Raval Sud-ICS (Barcelona) y redGDPS, Barcelona, España. Electronic address: josep.franch@gmail.com.
Josep Franch
JF
Nadal
Sección de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España.
Pedro Conthe
PC
Gutiérrez
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002423:Cause of Death; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D003925:Diabetic Angiopathies / Q000517:prevention & control; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000188:drug therapy / Q000453:epidemiology; D015337:Multicenter Studies as Topic; D009765:Obesity / Q000453:epidemiology; D011379:Prognosis; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D057185:Sedentary Behavior
D000959:Antihypertensive Agents; D001786:Blood Glucose; D000960:Hypolipidemic Agents
Cardiovascular risk; Control metabólico; Diabetes mellitus; Factor de riesgo; Metabolic control; Metabolic syndrome; Riesgo cardiovascular; Risk factor; Síndrome metabólico