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2003, Number s1

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Arch Cardiol Mex 2003; 73 (s1)

Atherosclerosis control in diabetes mellitus

Quiroz MA
Full text How to cite this article

Language: Spanish
References: 5
Page: 125-127
PDF size: 41.90 Kb.


Key words:

Diabetes mellitus, Atherosclerosis, Cardiovascular risk.

ABSTRACT

Diabetic patients develop atherosclerosis in an accelerated way as compared to non-diabetic patients. This is due to a generalized metabolic disorder that includes hyperglycemia, insulin resistance, dyslipidosis, loss of the endothelial regulatory function, a tendency for vasoconstriction, and a prothrombotic state. The main complications are coronary artery disease, peripheral vascular disease, and cerebrovascular disease. In all these manifestations and at all severity levels, diabetic patients, in particular post-menopausal women, have the worst prognosis with any type of treatment as compared to non-diabetic patients. These findings lead to consider the sole presentation of diabetes mellitus to be equivalent to cardiovascular risk. The largest reduction in risk is achieved by controlling hypertension, followed by a control of glycemia, reduction of glycosylated hemoglobulin and control of dyslipidosis. Benefits in the cardiovascular realm have not extended to other vascular territories, such as the lower extremities or the brain.


REFERENCES

  1. United Kingdom Prospective Diabetes Study Group: British Medical Journal 1998; 317: 703-720.

  2. Hu FB, Stampfer MJ, et al: The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women. Arch Intern Med 2001; 161: 1717-1723.

  3. Influence of diabetes on 5 year mortality and morbility in a randomized trial comparing CABG and PTCA in patients with multivessel disease. Circulation 1997; 96: 1761-1769.

  4. Malmberg K, Yusuf S, et al: Impact of diabetes on long term prognosis in patients with unstable angina and non-Q-wave myocardial infarction: results of the OASIS registry. Circulation 2000; 102: 1014-1019.

  5. The Bypass Angioplasty Revascularization Investigators: Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N England Journal of Medicine 1996; 335: 217-225.




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Arch Cardiol Mex. 2003;73