Marks J B, Raskin P
Department of Medicine, Division of Diabetes Endocrinology and Metabolism, University of Miami School of Medicine, FL 33136, USA.
J Diabetes Complications. 2000 Mar-Apr;14(2):108-15. doi: 10.1016/s1056-8727(00)00065-9.
Cardiovascular disease (CVD) is the major cause of the morbidity and mortality associated with diabetes in the US. A 2- to 3-fold incidence of CVD occurs in both type 1 and type 2 diabetic individuals over that in age- and gender-matched non-diabetic persons. Recent encouraging data demonstrating a decline in CVD mortality in the general US population do not reflect such a decline in the diabetic population, particularly in women. Increased risk for CVD is related to duration of diabetes and hyperglycemia, as well as hypertension, dyslipidemia, insulin resistance, gender, coagulation abnormalities, and other factors. Health care providers need to advocate for an uncompromising, multi-component attack on all modifiable risk factors for CVD, including glucose control, in the person with diabetes mellitus. This review focuses on known modifiable risk factors for CVD associated with diabetes, potential targets for primary and secondary prevention.
在美国,心血管疾病(CVD)是与糖尿病相关的发病和死亡的主要原因。1型和2型糖尿病患者发生CVD的几率是年龄和性别匹配的非糖尿病者的2至3倍。最近有令人鼓舞的数据表明,美国普通人群的CVD死亡率有所下降,但糖尿病患者群体,尤其是女性,并未出现这种下降。CVD风险增加与糖尿病病程、高血糖以及高血压、血脂异常、胰岛素抵抗、性别、凝血异常和其他因素有关。医疗保健提供者需要倡导对糖尿病患者的所有可改变的CVD风险因素,包括血糖控制,采取毫不妥协的多方面应对措施。本综述重点关注与糖尿病相关的已知可改变的CVD风险因素,以及一级和二级预防的潜在目标。