Diabetes, hypertension, and cardiovascular disease - An update

Citation
Jr. Sowers et al., Diabetes, hypertension, and cardiovascular disease - An update, HYPERTENSIO, 37(4), 2001, pp. 1053-1059
Citations number
60
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
HYPERTENSION
ISSN journal
0194-911X → ACNP
Volume
37
Issue
4
Year of publication
2001
Pages
1053 - 1059
Database
ISI
SICI code
0194-911X(200104)37:4<1053:DHACD->2.0.ZU;2-R
Abstract
Cardiovascular diseases (CVDs) are the major causes of mortality in persons with diabetes, and many factors, including hypertension, contribute to thi s high prevalence of CVD. Hypertension is approximately twice as frequent i n patients with diabetes compared with patients without the disease. Conver sely, recent data suggest that hypertensive persons are more predisposed to the development of diabetes than are normotensive persons. Furthermore, up to 75% of CVD in diabetes may be attributable to hypertension, leading to recommendations for more aggressive treatment tie, reducing blood pressure to < 130/85 mm Hg) in persons with coexistent diabetes and hypertension. Ot her important risk factors for CVD in these patients include the following: obesity, atherosclerosis, dyslipidemia, microalbuminuria, endothelial dysf unction, platelet hyperaggregability, coagulation abnormalities, and "diabe tic cardiomyopathy." The cardiomyopathy associated with diabetes is a uniqu e myopathic state that appears to be independent of macrovascular/microvasc ular disease and contributes significantly to CVD morbidity and mortality i n diabetic patients, especially those with coexistent hypertension. This up date reviews the current knowledge regarding these risk factors and their t reatment, with special emphasis on the cardiometabolic syndrome, hypertensi on, microalbuminuria, and diabetic cardiomyopathy. This update also examine s the role of the renin-angiotensin system in the increased risk for CVD in diabetic patients and the impact of interrupting this system on the develo pment of clinical diabetes as well as CVD.