The Burden Of Diabetes On Cardiovascular System

Among the various cardiovascular events related to hypertension and diabetes, two of them are very specifically related to hypertension: stroke and cardiac failure. These events are especially frequent and serious in type II diabetics. By contrast, myocardial infarction is less specifically due to hypertension, and may be currently prevented through other approaches like lipid-lowering and antiplatelet agents. In type II diabetes patients, the benefit of antihypertensive treatment is extremely high for the prevention of both stroke and cardiac failure, as illustrated by the results of the hypertension part of the UKPDS study: the relative risk reductions were 44%and 56%, respectively.PathophysiologyThe relationship between fasting blood glucose and cardiovascular risk on the one hand, and microangiopathy on the other, have been well described. As outlined by the Whitehall study, excess risk for cardiovascular mortality starts beyond the mean 2 standard deviations of fasting blood glucose, i.e. roughly 6 mM. (Fuller, Shipley et al. 1983)Conversely, the risk for microcirculatory complications starts from 7 mM fasting blood glucose [this risk makes the definition of diabetes mellitus] .(2001)