Doença cardiovascular no diabetes mellitus: análise dos fatores de risco clássicos e não-clássicos

Abstract

Cardiovascular disease, which includes coronary heart disease (CHD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD), is the leading cause of mortality in populations, particularly in the diabetic one. Individuals with diabetes have at least a two-fold to four-fold increased risk of having cardiovascular events and a double risk of death compared with age-matched subjects without diabetes. A decline in mortality from CVD has been shown, but decline due to CHD is consistently lower in individuals with diabetes when compared with non-diabetics. The presence of several factors in diabetes leads to high occurrence of CVD such as hyperglycemia, insulin resistance, and classical and non-classical risk factors (systemic hypertension, dyslipidemia, obesity, proinflammatory condition and others). It is possible that the atherogenic role of obesity may be at least in part due to increased adipocyte production of cytokines. Considering the marked association of diabetes and CVD and unfavorable prognosis following an event, it is important to identify who is at high risk and how to screen. The American Heart Association and American Diabetes Association recommend risk stratification using diagnostic tests. However, the challenge is to accurately identify patients without a prior history of an event and those without symptoms strongly suggesting CVD, in whom additional testing would be indicated in order to achieve the most effective prevention. The benefits of glycemic control and the other risk factors have already been shown and justify optimization of the management of this high-risk population, aiming to reduce cardiovascular mortality disease and improve quality of life.

Association between triglycerides and HDL-cholesterol ratio and cardiovascular risk factors among elderly persons receiving care under the family health strategy of Viçosa, Minas Gerais

“…In a review of literature it was observed that diabetic individuals had a three to four times greater risk of suffering a cardiovascular event and twice the risk of dying from this event than the general population 29 .…”

Self-esteem in patients with diabetes mellitus and foot ulcers

“…However, the dynamics of living can be completely different when the level of education is higher, since patients with a higher level of education often have more job opportunities and higher salaries [17].…”

Association of classical risk factors and coronary artery disease in type 2 diabetic patients submitted to coronary angiography

“…Acceleration of atherosclerosis in these patients can be due to insulin deficiency, defective insulin action, and hyperglycemia or associated metabolic defects [6]. Arterial hypertension and dyslipidemia frequently coexist with diabetes and contribute to the increased prevalence of CVD in diabetic patients [7-9]. The impact of some of these metabolic factors may be amplified by the presence of hyperglycemia.…”