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Diabetes mellitus and cardiovascular risk: just another risk factor?

C. Torp-Pedersen*,1, C. Rask-Madsen2, I. Gustafsson3, F. Gustafsson1 and L. Køber4

a Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
b Joslin Diabetes Center, Boston, Massachusetts, U.S.A.
c Frederiksberg University Hospital, Copenhagen, Denmark
d The Heart Center, Rigshopitalet University Hospital, Copenhagen, Denmark

* Professor Christian Torp-Pedersen, MD, Department of Cardiology, Bispebjerg University Hospital, 2400 Copenhagen, Denmark

Abstract

Patients with type 2 diabetes are at increased risk of developing cardiovascular disease. Also, individuals with cardiovascular disease have a poorer prognosis if they are diagnosed with type 2 diabetes. The coexistence of these two disorders increases the risk for morbidity and mortality from large- and small-vessel disease. The importance of dysfunctional glucose metabolism is apparent even at the earliest stages of vascular disease, with insulin resistance contributing to or arising from endothelial dysfunction. In the clinical setting, antihypertensive treatment. Produces proportionally greater benefits in patients with type 2 diabetes than in non-diabetic individuals, and treatments that lower blood glucose reduce the risk of cardiovascular complications. As more becomes known about the inter-relationship of glycometabolic control and cardiovascular disease, the aetiology, pathology and treatment of the two diseases are becoming increasingly entwined. The present review summarizes the importance of type 2 diabetes in cardiovascular disease and discusses some of the therapeutic implications that arise from newly emerging data.

Key Words: Cardiovascular disease • Hypertension • Myocardial infarction • Risk factors • Type 2 diabetes mellitus

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