The Independent Effect of Type 2 Diabetes Mellitus on Ischemic Heart Disease, Stroke, and Death

Almdal, Thomas; Scharling, Henrik; Jensen, Jan Skov; Vestergaard, Henrik

doi:10.1001/archinte.164.13.1422

Cited by 571 publications

(383 citation statements)

References 17 publications

(17 reference statements)

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“…3 Mortality from cardiovascular disease may be up to four times higher in patients with T2DM. 4 The hypertension which typically accompanies T2DM appears to be the most significant contributor to this increased risk. 5 Endothelium derived nitric oxide (NO) is a potent vasodilator which plays a pivotal role in the moment to moment control of vascular tone.…”

Section: Introductionmentioning

confidence: 99%

Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes

Gilchrist

Winyard

Aizawa

et al. 2013

Free Radical Biology and Medicine

217

209

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Diets rich in green, leafy vegetables have been shown to lower BP and reduce the risk of cardiovascular disease. Green, leafy vegetables and beetroots are particularly rich in inorganic nitrate. Dietary nitrate supplementation, via sequential reduction to nitrite and NO, has previously been shown to lower BP and improve endothelial function in healthy humans.We sought to determine if supplementing dietary nitrate with beetroot juice, a rich source of nitrate, will lower BP, improve endothelial function and insulin sensitivity in individuals with type 2 diabetes (T2DM). Twenty-seven patients, age 67.2 +/-4.9 years, (18 male) were recruited for a double blind, randomised, placebo-controlled crossover trial. Participants were randomised to begin in either order a 2 week period of supplementation with 250 ml beetroot juice daily (active) or 250 ml nitratedepleted beetroot juice (placebo). At the conclusion of each intervention period 24 hour ambulatory blood pressure monitoring, tests of macro and microvascular endothelial function and a hyperinsulinaemic isoglycaemic clamp were performed. After two weeks administration of beetroot juice mean ambulatory systolic BP was unchanged: 134.6 ± 8.4 mmHg versus 135.1 ± 7.8 mmHg (mean ± SD) placebo vs. active -mean difference of -0.5 mmHg (placebo-active), p=0.737 (95% CI -3.9 to 2.8). There were no changes in macrovascular or microvascular endothelial function or insulin sensitivity. Supplementation of the diet with 7.5 mmoles of nitrate per day for 2 weeks caused an increase in plasma nitrite and nitrate concentration, but did not lower BP, improve endothelial function or insulin sensitivity in individuals with T2DM.3

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Section: Introductionmentioning

confidence: 99%

Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes

Gilchrist

Winyard

Aizawa

et al. 2013

Free Radical Biology and Medicine

217

209

View full text Add to dashboard Cite

show abstract

“…It has been demonstrated that patients with type 2 diabetes mellitus have a 2-to 3-fold higher risk of cardiovascular disease (CVD) and premature mortality vs the general population [1]. Measures of abdominal obesity, principally waist circumference, which more accurately describe the distribution of body fat than body mass index (BMI), are thought to be more closely associated with the risk of CVD and subsequent mortality [2].…”

Section: Introductionmentioning

confidence: 99%

Intake of brown rice lees reduces waist circumference and improves metabolic parameters in type 2 diabetes

Kim

Lee

et al. 2011

Nutrition Research

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“…[14][15][16][17][18] In populations free of cardiovascular disease at baseline, cardiovascular morbidity and mortality increased 1.5-to 3-fold in the presence of metabolic syndrome 10,[19][20][21] and two-to fourfold in the presence of type II diabetes. 22 In spite of the use of different and modified definitions, the metabolic syndrome is associated with more extensive vascular damage and increased risk for subsequent events in patients with prevalent cardiovascular disease. 12,23,24 In hypertensive patients without manifest vascular disease, the metabolic syndrome has been shown to be associated with increased intima-media thickness and left ventricular hypertrophy as well as with increased incidence of cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

Effect of metabolic syndrome or type II diabetes mellitus on the occurrence of recurrent vascular events in hypertensive patients

et al. 2008

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Patients with hypertension and manifest vascular disease are at high risk for recurrent cardiovascular diseases. It is unknown if the metabolic syndrome further increases the risk in these patients. This study aims to quantify the effect of metabolic syndrome and type II diabetes on cardiovascular events in hypertensive patients with vascular disease. A total of 2196 hypertensive patients with vascular disease (cerebrovascular disease (34%), coronary heart disease (50%), peripheral arterial disease (28%), abdominal aortic aneurysm (13%)) from the Second Manifestations of Arterial Disease study were followed for up to 10 years (mean 3.9 years) for death, stroke and myocardial infarction. Age and sex adjusted hazard ratios (HR) were calculated for hypertensive patients with metabolic syndrome but without diabetes (n ¼ 775) and for hypertensive patients with type II diabetes (n ¼ 381), compared to merely hypertensive patients (n ¼ 1040).Forty-nine percent had metabolic syndrome (NCEP ATPIII definition) and 17% had type II diabetes. Metabolic syndrome predicted vascular death (HR 1.41, 95% confidence interval (CI) 1.01-1.98), stroke (HR 1.36, 95% CI 0.85-2.16) and myocardial infarction (HR 1.40, 95% CI 0.97-2.01). Type II diabetes accounted for even higher risks of vascular end points (HR 1.41-1.64). The effect of metabolic syndrome on future events could not be explained by the presence of type II diabetes. Even in high-risk patients with hypertension and vascular disease, presence of metabolic syndrome or type II diabetes identifies patients at high risk for future cardiovascular events. Identifying metabolic syndrome patients may direct therapy focusing on treatment of insulin resistance by reducing weight and increasing physical activity.

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The Independent Effect of Type 2 Diabetes Mellitus on Ischemic Heart Disease, Stroke, and Death

Abstract: In persons with type 2 DM, the risk of having an incident myocardial infarction or stroke is increased 2- to 3-fold and the risk of death is increased 2-fold, independent of other known risk factors for cardiovascular diseases.

Cited by 571 publications

References 17 publications

Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes

Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes

Intake of brown rice lees reduces waist circumference and improves metabolic parameters in type 2 diabetes

Effect of metabolic syndrome or type II diabetes mellitus on the occurrence of recurrent vascular events in hypertensive patients

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