Abstract
In BriefCardiovascular disease (CVD) is a common complication of diabetes; nearly 80% of all people with diabetes will die from macrovascular complications. Dyslipidemia, hypertension, hypercoagulability, poor glycemic control,smoking, obesity, and lack of physical activity are just some of the multiple risk factors responsible for the increased risk of CVD in diabetes. A multi-pronged approach to address these risk factors is imperative. Although nonpharmacological therapy is the cornerstone of treatment, some pharmacological treatments are almost always warranted. These may include statins for dyslipidemia and their pleiotropic effects, tight blood pressure control (especially with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers), antiplatelet therapy, and appropriately tight glycemic control based on comorbidities. Evidence has shown that this approach can reduce the risk of CVD in diabetes but that these strategies continue to be underutilized.
Highlights
Cardiovascular disease (CVD) is a common complication of diabetes; nearly 80% of all people with diabetes will die from macrovascular complications
80% of people with diabetes will die as a result of cardiovascular disease (CVD)
Seven-year followup data have shown that people with diabetes but no CVD have the same risk as those who do not have diabetes but who have already had a myocardial infarction (MI)
Summary
Risk factors for CVD must be treated aggressively in people with diabetes because cardiovascular outcomes are often worse compared to people without diabetes. To reduce the CVD burden common among individuals with diabetes, it is imperative to implement multifactorial interventions that include diet, exercise, smoking cessation, and obesity management. Pharmacological therapy is another crucial intervention that should be initiated in most people with diabetes. The reasons are multifactorial, but require action when an abnormal parameter is identified; adequate follow-up and education of the practitioner, patient, and health system; and an active partnership with people with diabetes. In this high-risk population, intensive, multifactorial intervention gives the patient the best chance of avoiding CVD
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