Diabetes as a risk factor for cardiovascular disease
If you have diabetes you are two to four times more likely to develop cardiovascular disease than people without diabetes. Cardiovascular disease is the leading cause of mortality for people with diabetes.
If you have diabetes your risk of cardiovascular disease rises for a number of reasons.
- abnormal blood lipids and
Abundant evidence shows that patients with type 1 diabetes or type 2 diabetes are at high risk for several cardiovascular disorders:
- coronary heart disease,
- peripheral arterial disease,
- cardiomyopathy, and
- congestive heart failure.
Cardiovascular complications are now the leading causes of diabetes-related morbidity and mortality. The public health impact of cardiovascular disease (CVD) in patients with diabetes is already enormous and is increasing. Several explanations are behind this increase.
First, the incidence of diabetes rises with advancing age, and the number of older people is growing rapidly.
Second, insulin treatment for persons with type 1 diabetes has prolonged their lives significantly, and with each year of additional life comes an increased risk for CVD complications.
Third, type 2 diabetes occurs at an earlier age in obese and overweight persons, and the prevalence of obesity. The risk for diabetes in overweight persons is heightened by physical inactivity; unfortunately.
Diabetes has long been recognized to be an independent risk factor for CVD. The adverse influence of diabetes extends to all components of the cardiovascular system: the microvasculature, the larger arteries, and the heart, as well as the kidneys. Because of the increasing prevalence of diabetes in our society, it now rivals cigarette smoking, hypertension, and cholesterol disorders as major risk factors for CVD. It is a particularly strong risk factor among women and among the growing elderly population. In recent years, the National Institutes of Health, through programs of the National Heart, Lung, and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases, has substantially increased research on cardiovascular complications of diabetes. They have also noted the special risk of CVD among diabetic patients in guidelines and educational programs.
An important reason to become more aggressive about the cardiovascular complications of diabetes resides in the positive results achieved in recent clinical trials. Recent controlled trials of cholesterol-lowering therapy, particularly secondary prevention trials, showed that reducing low-density lipoprotein cholesterol levels results in a striking decrease in major coronary events in patients with type 2 diabetes.
Goals of health care practitioners in prevention of diabetes
The ultimate goal of public health and clinical intervention is the prevention of diabetes and its complications. All of the signatory organizations reaffirm their commitment to efforts to better understand the causes and unique factors that contribute to excess risk for premature CVD and to develop and implement improved interventions. All will emphasize the prevention of type 2 diabetes through their efforts to reduce obesity and promote physical activity in the general population. In addition to prevention, however, is the need to increase the use of currently available tools in the management of diabetes, in part through control of risk factors to prevent or mitigate the complications of the disease and in part through better treatment of these complications. As a result, the organizations listed above will initiate new collaborative research and new educational programs that focus on CVD and diabetes