RT Book, Section A1 Farkouh, Michael E. A1 Rayfield, Elliot J. A1 Fuster, Valentin A2 Fuster, Valentin A2 Harrington, Robert A. A2 Narula, Jagat A2 Eapen, Zubin J. SR Print(0) ID 1191186843 T1 DIABETES AND CARDIOVASCULAR DISEASE T2 Hurst's The Heart, 14e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071843249 LK accessmedicine.mhmedical.com/content.aspx?aid=1191186843 RD 2024/03/28 AB SummaryThis chapter discusses the development, prevention, and management of cardiovascular disease in patients with diabetes mellitus. The number of patients with diabetes is rapidly increasing, and the condition is a major risk factor for the development of cardiovascular disease (see accompanying Hurst’s Central Illustration). A major macrovascular complication of diabetes is coronary heart disease, the leading cause of death in patients with type 2 diabetes. Diabetes-related cardiomyopathy and heart failure is also a concern; compared with individuals who do not have diabetes, risk of heart failure is double in men and five-fold higher in women with diabetes. Additionally, in diabetic patients, stoke-related mortality is almost three-fold higher than in the nondiabetic individuals. Mechanisms of development of cardiovascular disease in patients with diabetes and insulin resistance include hyperglycemia, dyslipidemia, hypercoagulability, inflammation, endothelial dysfunction, and vascular smooth muscle cell proliferation and migration. A major focus in the management of patients with type 1 or type 2 diabetes is the prevention of cardiovascular disease. Strategies known to reduce cardiovascular events in patients with diabetes include diet and lifestyle modification, good glycemic control, effective management of dyslipidemia and hypertension, and antiplatelet therapy.