Diabetes mellitus and coronary heart disease.

The prevalence of diabetes mellitus rises with age in men and women in the United States and in westernized regions, and the risk of vascular disease is typically increased twofold in diabetic men and threefold in diabetic women. Population-based data concerning the prevalence of diabetes mellitus and its impact on coronary heart disease (CHD) are reviewed. The vascular disease endpoints considered include death, angina pectoris, myocardial infarction (MI), cardiac failure, cardiac arrhythmias, and the experience of diabetics who have undergone angioplasty and revascularization. The impact of coronary risk factors in diabetics is considered for glycemic control, arterial pressure, microalbuminuria, and lipids. Recent guidelines and recommendations concerning lipids, glucose, and blood pressure for diabetics are discussed.