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Diabetes and the Cardiovascular System

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Abstract

Diabetes has become a worldwide epidemic. The majority of patients with diabetes ultimately die from complications of cardiovascular disease. The mechanisms underlying macrovascular disease in diabetes are incompletely understood but likely involve inflammation and alterations of the endothelium and vascular smooth muscle. An increasing proportion of patients hospitalized with acute coronary syndromes will have diabetes. These patients tend to have worse outcomes and are less likely to receive guideline-based therapy. Prevention of cardiovascular disease in both type 1 and type 2 diabetes is an area of increasing focus and complexity. Both diabetes and prediabetes commonly carry with them cardiovascular risk factors including dyslipidemia, hypertension, hyperglycemia, obesity, and sedentary lifestyle. Intensive glucose control has not been shown to improve macrovascular outcomes in patients with diabetes. A number of explanations for this counterintuitive data have been proposed, and ongoing studies are needed for further clarification. New antidiabetic drugs and therapeutic strategies are being pursued, including their effects on macrovascular outcomes. Multifactorial risk factor modification appears to be particularly effective in preventing cardiovascular events, underscoring the critical need for careful management of risk factors in patients with diabetes.

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Recommended Readings

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Authors and Affiliations

  1. Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, NRB 742, Boston, MA, 02115, USA

    Paul Cohen MD, PhD & Jorge Plutzky MD

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  1. Paul Cohen MD, PhD
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  2. Jorge Plutzky MD
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Correspondence to Jorge Plutzky MD .

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  1. The Mount Sinai School of Medicine, The James J. Peters VA Medical Center, Department of Medicine, West Kingsbridge Rd 130, Bronx, 10468, New York, USA

    Clive Rosendorff

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Cohen, P., Plutzky, J. (2013). Diabetes and the Cardiovascular System. In: Rosendorff, C. (eds) Essential Cardiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6705-2_41

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  • DOI: https://doi.org/10.1007/978-1-4614-6705-2_41

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