title: Predicting cardiovascular risk in type 2 diabetes: the heterogeneity challenges.
abstract: Type 2 diabetes mellitus has reached epidemic proportions around the world, and the increase in cardiovascular risk attributable to diabetes estimated to range from 2- to 4-fold poses grave public health concern. Though in some contexts type 2 diabetes has been equated with coronary heart disease equivalent risk, there is considerable evidence that incremental cardiovascular risk does not uniformly affect all people with type 2 diabetes. This heterogeneity in cardiovascular risk is multifactorial and only partially understood but is a key consideration for our understanding of the nexus of diabetes and cardiovascular disease and for the development of optimal and individualized cardiovascular risk reduction strategies. This review provides a brief synopsis of the concept of cardiovascular risk heterogeneity in diabetes, including epidemiologic evidence, discussion of established and potential determinants of heterogeneity, and clinical, research, and regulatory implications.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA, Maria.Gore@UTSouthwestern.edu.
authors.forename: M Odette
authors.initials: MO
authors.lastname: Gore
authors.forename: Darren K
authors.initials: DK
authors.lastname: McGuire
authors.forename: Ildiko
authors.initials: I
authors.lastname: Lingvay
authors.forename: Julio
authors.initials: J
authors.lastname: Rosenstock
mesh_terms: D017677:Age Distribution; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000150:complications* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008019:Life Style; D009765:Obesity / Q000150:complications* / Q000517:prevention & control; D011237:Predictive Value of Tests; D011634:Public Health; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology