Elsevier

Cardiology Clinics

Volume 22, Issue 4, November 2004, Pages 553-568
Cardiology Clinics

Diabetes mellitus and heart failure: basic mechanisms, clinical features, and therapeutic considerations

https://doi.org/10.1016/j.ccl.2004.07.002Get rights and content

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Heart failure in diabetes mellitus: causal and treatment considerations

The combination of hyperglycemia, hypertension, obesity, dyslipidemia, and atherosclerosis that is seen commonly with diabetes mellitus increases the risk of systolic and diastolic left ventricular (LV) dysfunction and often leads to heart failure in diabetic patients; this explains the more common occurrence of this syndrome in diabetic patients [1], [2], [3], [4]. In the United Kingdom Prospective Diabetic Study (UKPDS), the incidence of heart failure correlated with the extent of

Glycemic control

Although intensive glycemic control may not alter indices of systolic function [102], data from the UKPDS clearly demonstrated that intensive blood pressure reduction (mean: 144/88 mm Hg) and glucose control (mean HgbA1c = 7.0%) reduced stroke, microvascular outcomes, death, and all diabetes end points [103], [104]. Although blood pressure control (even with a blood pressure reduction less than that recommended by Joint National Committee [JNC] VI and American Diabetes Association [ADA]

Summary

Diabetic cardiomyopathy encompasses the spectrum from subclinical disease to the full-blown syndrome of congestive heart failure. The prevalence of type 2 diabetes mellitus is increasing at an alarming rate in the western world, and with it, the frequency of diabetes-related heart failure. There is at least early suggestion that target-driven, long-term, intensified intervention that is aimed at multiple risk factors in patients who have type 2 diabetes and microalbuminuria may reduce the risk

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