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American Journal of Cardiovascular Drugs

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01-07-2003 | Review Article

Preventing Macrovascular Disease in Patients with Type 2 Diabetes Mellitus

Authors: Odd E. Johansen, Kåre I. Birkeland

Published in: American Journal of Cardiovascular Drugs | Issue 4/2003

Abstract

Type 2 diabetes mellitus (DM) is associated with an increased risk for both micro-and macrovascular complications, and cardiovascular diseases (CVD) are the most common causes of death in these patients, accounting for almost 70% of the deaths. Given the high prevalence of the condition and the expected global increase in the prevalence of type 2 DM, a case is made for prevention of these serious complications in order to reduce the individual morbidity and the economic burden on society. In this review we present the knowledge of how macrovascular disease in patients with type 2 DM may be prevented, and suggest possible strategies for doing so.

A thorough search of the published literature was conducted and we first present relevant epidemiological studies demonstrating the impact of important risk factors for CVD in DM, such as dyslipidemia, hyperglycemia, hypertension, smoking, familial premature coronary heart disease and some non-classical risk factors such as hyperinsulinemia, insulin resistance, endothelial dysfunction and inflammation. Secondly, we review the results from published randomized controlled clinical trials and meta-analysis of these, evaluate the findings and suggest strategies for preventing CVD in patients with type 2 DM using non-pharmacological and pharmacological approaches.

Present knowledge indicates that most patients with type 2 DM either have manifest CVD or have a high risk for future cardiovascular events, men with DM have a 2- to 4-fold; and women with DM a 3- to 5-fold increased risk for cardiovascular death compared with non-diabetic individuals. Care of patients with type 2 DM should include yearly risk assessment by the use of published risk equations or risk charts. On the background of this assessment, an individual risk reducing strategy should be tailored to each patient’s need, including the treatment of hyperglycemia, hypertension and dyslipidemia together with the use of aspirin (acetylsalicylic acid) and ACE inhibitors. Such measures can reduce the risk of cardiovascular events in patients with type 2 DM.

Yki-Jarvinen H. Pathogenesis of non-insulin-dependent diabetes mellitus. Lancet 1994; 343: 91–5PubMed

De Fronzo RA. Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver: a collusion responsible for NIDDM. Diabetes 1988; 37: 667–87

Groop LC, Widen E, Ferrannini E. Insulin resistance and insulin deficiency in the pathogenesis of type 2 (non-insulin-dependent) diabetes mellitus: errors of metabolism or of methods? Diabetologia 1993; 36: 1326–31PubMed

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications: Part 1. diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15: 539–53PubMed

Reaven GM. Banting lecture 1988: role of insulin resistance in human disease. Diabetes 1988; 37: 1595–607PubMed

De Fronzo RA, Ferrannini E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: 173–94

Groop L. Genetics of the metabolic syndrome. Br J Nutr 2000; 83 Suppl. 1: S39–48PubMed

Alberti KG, Gries FA. Management of non-insulin-dependent diabetes mellitus in Europe: a consensus view. Diabet Med 1988; 5: 275–81PubMed

Bierman EL. George Lyman Duff Memorial Lecture: Atherogenesis in diabetes. Arterioscler Thromb 1992; 12: 647–56PubMed

10.

Pyorala K, Laakso M, Uusitupa M. Diabetes and atherosclerosis: an epidemiologic view. Diabetes Metab Rev 1987; 3: 463–524PubMed

11.

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 1998; 21: 1414–31PubMed

12.

Harris MI, Flegal KM, Cowie CC, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults. The Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes Care 1998; 21: 518–24PubMed

13.

Riste L, Khan F, Cruickshank K. High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city: relative poverty, history, inactivity, or 21st century Europe? Diabetes Care 2001; 24: 1377–83PubMed

14.

Drivsholm T, Ibsen H, Schroll M, et al. Increasing prevalence of diabetes mellitus and impaired glucose tolerance among 60-year-old Danes. Diabet Med 2001; 18: 126–32PubMed

15.

McKeigue PM, Marmot MG, Syndercombe-Court YD, et al. Diabetes, hyperinsulinaemia, and coronary risk factors in Bangladeshis in East London. Br Heart J 1988; 60: 390–6PubMed

16.

McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991; 337: 382–6PubMed

17.

Kannel WB, McGee DL. Diabetes and cardiovascular disease: Framingham Study. JAMA 1979; 241: 2035–8PubMed

18.

Haffner SM, Lehto S, Rönnemaa T, et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339: 229–34PubMed

19.

Turner RC, Millns H, Neil HA, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 1998; 316: 823–8PubMed

20.

Stamler J, Vaccaro O, Neaton JD, et al. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 1993; 16: 434–44PubMed

21.

Lehto S, Ronnemaa T, Pyorala K, et al. Predictors of stroke in middle-aged patients with non-insulin-dependent diabetes. Stroke 1996; 27: 63–8PubMed

22.

Haire-Joshu D, Glasgow RE, Tibbs TL. Smoking and diabetes. Diabetes Care 1999; 22: 1887–98PubMed

23.

Rimm EB, Manson JE, Stampfer MJ, et al. Cigarette smoking and the risk of diabetes in women. Am J Public Health 1993; 83: 211–4PubMed

24.

Rimm EB, Chan J, Stampfer MJ, et al. Prospective study of cigarette smoking, alcohol use and the risk of diabetes in men. BMJ 1995; 310: 555–9PubMed

25.

Chaturvedi N, Sztevens L, Fuller JH. Which features of smoking determine mortality risk in former cigarette smokers with diabetes? The World Health Multinational Study Group. Diabetes Care 1997; 20: 1266–73PubMed

26.

Fuller JH, Stevens LK, Wang SL, et al. Risk factors for cardiovascular disease in diabetes mellitus: the WHO multinational study of vascular disease in diabetes. Diabetologia 2001; 44 Suppl. 2: S54–64PubMed

27.

Gress TW, Nieto FJ, Shahar E, et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000; 342: 905–12PubMed

28.

Ferrannini E, Buzzigoli G, Bonadonna R, et al. Insulin resistance in essential hypertension. N Engl J Med 1987; 317: 350–7PubMed

29.

Birkeland KI, Chatzipanagiotou F, Hanssen KF, et al. Relationship between blood pressure and in vivo action of insulin in type II (non-insulin-dependent) diabetic subjects. Metabolism 1992; 41: 301–5PubMed

30.

Groop L, Ekstrand A, Forsblom C, et al. Insulin resistance, hypertension and microalbuminuria in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 1993; 36: 642–7PubMed

31.

Lee ET, Keen H, Bennett PH, et al. Follow-up of the WHO Multinational Study of vascular disease in diabetes: general description and morbidity. Diabetologia 2001; 44 Suppl. 2: S3–13PubMed

32.

Adler AI, Stratton IM, Neil HA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000; 321: 412–9PubMed

33.

Parving HH, Andersen AR, Smidt UM, et al. Diabetic nephropathy and arterial hypertension. Diabetologia 1983; 24: 10–2PubMed

34.

Reaven GM, Hoffman BB. A role for insulin in the aetiology and course of hypertension? Lancet 1987; II: 435–7

35.

Julius S, Gudbrandsson T, Jamerson K, et al. The hemodynamic link between insulin resistance and hypertension. J Hypertens 1991; 9: 983–6PubMed

36.

West KM, Ahuja MM, Bennett PH, et al. The role of circulating glucose and triglyceride concentrations and their interactions with other “risk factors” as determinants of arterial disease in nine diabetic population samples from the WHO multinational study. Diabetes Care 1983; 6: 361–9PubMed

37.

Manson JE, Colditz GA, Stampfer MJ, et al. A prospective study of maturity-onset diabetes mellitus and risk of coronary heart disease and stroke in women. Arch Intern Med 1991; 151: 1141–7PubMed

38.

Lehto S, Ronnemaa T, Haffner SM, et al. Dyslipidemia and hyperglycemia predict coronary heart disease events in middle-aged patients with NIDDM. Diabetes 1997; 46: 1354–9PubMed

39.

Lamarche B, Tchernof A, Mauriege P, et al. Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. JAMA 1998; 279: 1955–61PubMed

40.

Gray RS, Robbins DC, Wang W, et al. Relation of LDL size to the insulin resistance syndrome and coronary heart disease in American Indians. The Strong Heart Study. Arterioscler Thromb Vasc Biol 1997; 17: 2713–20PubMed

41.

Vakkilainen J, Makimattila S, Seppala-Lindroos A, et al. Endothelial dysfunction in men with small LDL particles. Circulation 2000; 102: 716–21PubMed

42.

Veniant MM, Sullivan MA, Kim SK, et al. Defining the atherogenicity of large and small lipoproteins containing apolipoprotein B100. J Clin Invest 2000; 106: 1501–10PubMed

43.

Taskinen MR, Smith U. Lipid disorders in NIDDM: implications for treatment. J Intern Med 1998; 244: 361–70PubMed

44.

Salomaa VV, Tuomilehto J, Jauhiainen M, et al. Hypertriglyceridemia in different degrees of glucose intolerance in a Finnish population-based study. Diabetes Care 1992; 15: 657–65PubMed

45.

Reaven GM. Syndrome X: 6 years later. J Intern Med Suppl 1994; 736: 13–22PubMed

46.

Garg A. Treatment of diabetic dyslipidemia. Am J Cardiol 1998; 81: 47B–51BPubMed

47.

Haffner SM, D’Agostino Jr R, Mykkanen L, et al. Insulin sensitivity in subjects with type 2 diabetes: relationship to cardiovascular risk factors: the Insulin Resistance Atherosclerosis Study. Diabetes Care 1999; 22: 562–8PubMed

48.

Widen E, Ekstrand A, Saloranta C, et al. Insulin resistance in type 2 (non-insulin-dependent) diabetic patients with hypertriglyceridaemia. Diabetologia 1992; 35: 1140–5PubMed

49.

Coutinho M, Gerstein HC, Wang Y, et al. The relationship between glucose and incident cardiovascular events: a metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 1999; 22: 233–40PubMed

50.

Khaw KT, Wareham N, Luben R, et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ 2001; 322: 15–8PubMed

51.

DECODE Study Group. European Diabetes Epidemiology Group. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. Diabetes Epidemiology: collaborative analysis of diagnostic criteria in Europe. Lancet 1999; 354: 617–21

52.

Wei M, Gaskill SP, Haffner SM, et al. Effects of diabetes and level of glycemia on all-cause and cardiovascular mortality: The San Antonio Heart Study. Diabetes Care 1998; 21: 1167–72PubMed

53.

Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405–12PubMed

54.

Klein R. Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care 1995; 18: 258–68PubMed

55.

Jarrett RJ. Type 2 (non-insulin-dependent) diabetes mellitus and coronary heart disease-chicken, egg or neither? Diabetologia 1984; 26: 99–102PubMed

56.

United Kingdom Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53

57.

Stout RW. Insulin and atheroma — an update. Lancet 1987; 1(8541): 1077–9PubMed

58.

McFarlane SI, Banerji M, Sowers JR. Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab 2001; 86: 713–8PubMed

59.

Pyorala K. Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: results from two population studies in Finland. Diabetes Care 1979; 2: 131–41PubMed

60.

Cullen K, Stenhouse NS, Wearne KL, et al. Multiple regression analysis of risk factors for cardiovascular disease and cancer mortality in Busselton, Western Australia: 13-year study. J Chronic Dis 1983; 36: 371–7PubMed

61.

Ducimetiere P, Eschwege E, Papoz L, et al. Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. Diabetologia 1980; 19: 205–10PubMed

62.

Liu QZ, Knowler WC, Nelson RG, et al. Insulin treatment, endogenous insulin concentration, and ECG abnormalities in diabetic Pima Indians: cross-sectional and prospective analyses. Diabetes 1992; 41: 1141–50PubMed

63.

Welin L, Eriksson H, Larsson B, et al. Hyperinsulinaemia is not a major coronary risk factor in elderly men: the study of men born in 1913. Diabetologia 1992; 35: 766–70PubMed

64.

Ferrara A, Barrett-Connor EL, Edelstein SL. Hyperinsulinemia does not increase the risk of fatal cardiovascular disease in elderly men or women without diabetes: the Rancho Bernardo Study, 1984–1991. Am J Epidemiol 1994; 140: 857–69PubMed

65.

Howard G, O’Leary DH, Zaccaro D, et al. Insulin sensitivity and atherosclerosis. The Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Circulation 1996; 93: 1809–17PubMed

66.

Yip J, Facchini FS, Reaven GM. Resistance to insulin-mediated glucose disposal as a predictor of cardiovascular disease. J Clin Endocrinol Metab 1998; 83: 2773–6PubMed

67.

Lehto S, Ronnemaa T, Pyorala K, et al. Cardiovascular risk factors clustering with endogenous hyperinsulinaemia predict death from coronary heart disease in patients with type II diabetes. Diabetologia 2000; 43: 148–55PubMed

68.

Pyorala M, Miettinen H, Halonen P, et al. Insulin resistance syndrome predicts the risk of coronary heart disease and stroke in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. Arterioscler Thromb Vasc Biol 2000; 20: 538–44PubMed

69.

Pi-Sunyer FX. Weight and non-insulin-dependent diabetes mellitus. Am J Clin Nutr 1996; 63: 426S–9SPubMed

70.

Larsson B, Svardsudd K, Welin L, et al. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed) 1984; 288: 1401–4

71.

Chaturvedi N, Fuller JH. Mortality risk by body weight and weight change in people with NIDDM. The WHO Multinational Study of Vascular Disease in Diabetes. Diabetes Care 1995; 18: 766–74PubMed

72.

Dinneen SF, Gerstein HC. The association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus: a systematic overview of the literature. Arch Intern Med 1997; 157: 1413–8PubMed

73.

Gall MA, Borch-Johnsen K, Hougaard P, et al. Albuminuria and poor glycemic control predict mortality in NIDDM. Diabetes 1995; 44: 1303–9PubMed

74.

Mattock MB, Morrish NJ, Viberti G, et al. Prospective study of microalbuminuria as predictor of mortality in NIDDM. Diabetes 1992; 41: 736–41PubMed

75.

Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Engl J Med 1984; 310: 356–60PubMed

76.

Schmitz A, Vaeth M. Microalbuminuria: a major risk factor in non-insulin-dependent diabetes: a 10-year follow-up study of 503 patients. Diabet Med 1988; 5: 126–34PubMed

77.

Jilma B, Dallinger S, Hergovich N, et al. Effects of hyperinsulinemia on plasma levels of circulating adhesion molecules. J Clin Endocrinol Metab 2000; 85: 1748–51PubMed

78.

Schachinger V, Britten MB, Zeiher AM. Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. Circulation 2000; 101: 1899–906PubMed

79.

Stuhlinger MC, Abbasi F, Chu JW, et al. Relationship between insulin resistance and an endogenous nitric oxide synthase inhibitor. JAMA 2002; 287: 1420–6PubMed

80.

Colwell JA, Winocour PD, Lopes-Virella M, et al. New concepts about the pathogenesis of atherosclerosis in diabetes mellitus. Am J Med 1983; 75: 67–80PubMed

81.

Westerbacka J, Yki-Jarvinen H, Turpeinen A, et al. Inhibition of platelet-collagen interaction: an in vivo action of insulin abolished by insulin resistance in obesity. Arterioscler Thromb Vasc Biol 2002; 22: 167–72PubMed

82.

Howard BV, Cowan LD, Go O, et al. Adverse effects of diabetes on multiple cardiovascular disease risk factors in women: the Strong Heart Study. Diabetes Care 1998; 21: 1258–65PubMed

83.

Tuomilehto J, Lindström J, Eriksson J, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–50PubMed

84.

Diabetes Prevention Program Control Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403

85.

UK prospective study of therapies of maturity-onset diabetes: I effect of diet, sulphonylurea, insulin or biguanide therapy on fasting plasma glucose and body weight over one year. Diabetologia 1983; 24: 404–11

86.

Brown SA, Upchurch S, Anding R, et al. Promoting weight loss in type II diabetes. Diabetes Care 1996; 19: 613–24PubMed

87.

Wing RR, Venditti E, Jakicic JM, et al. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 1998; 21: 350–9PubMed

88.

King AC, Tribble DL. The role of exercise in weight regulation in nonathletes. Sports Med 1991; 11: 331–49PubMed

89.

Yudkin J. How can we best prolong life? benefits of coronary risk factor reduction in non-diabetic and diabetic subjects. BMJ 1993; 306: 1313–8PubMed

90.

United Kingdom Prospective Diabetes Study Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998; 352: 854–65

91.

Meinert CL, Knatternd GL, Prout TE, et al. A study of the effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes: II. mortality results. Diabetes 1970; 19 Suppl.: 789–830PubMed

92.

Abraira C, Colwell J, Nuttall F, et al. Cardiovascular events and correlates in the Veterans Affairs Diabetes Feasibility Trial: Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type II Diabetes. Arch Intern Med 1997; 157: 181–8PubMed

93.

Hanefeld M, Fischer S, Schmechel H, et al. Diabetes intervention study: multi-intervention trial in newly diagnosed NIDDM. Diabetes Care 1991; 14: 308–17PubMed

94.

Hanefeld M, Fischer S, Julius U, et al. Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up. Diabetologia 1996; 39: 1577–83PubMed

95.

Gaede P, Vedel P, Parving HH, et al. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study. Lancet 1999; 353: 617–22PubMed

96.

Malmberg K, Rydén L, Efendic S, et al. Randomised trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI Study): effects on mortality at 1 year. J Am Coll Cardiol 1995; 26: 57–65PubMed

97.

Malmberg K. Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus. DIGAMI (Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction) Study Group. BMJ 1997; 314: 1512–5PubMed

98.

Estacio RO, Jeffers BW, Hiatt WR, et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med 1998; 338: 645–52PubMed

99.

Hansson L, Lindholm L, Niskanen L, et al. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet 1999; 353: 611–6PubMed

100.

Tatti P, Pahor M, Byington RP, et al. Outcome results of the fosinopril versus amlodipine cardiovascular events randomized trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998; 21: 597–603PubMed

101.

Curb J, Pressel S, Cutler J, et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension: Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA 1996; 276: 1886–92PubMed

102.

Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet 1998; 351: 1755–62PubMed

103.

Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253–9

104.

Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the hypertension detection and follow-up program: I. reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 1979; 242: 2562–71

105.

Hansson L, Lindholm LH, Ekbom T, et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet 1999; 354: 1751–6PubMed

106.

Wang JG, Staessen JA, Gong L, et al. Chinese trial on isolated systolic hypertension in the elderly. Systolic Hypertension in China (Syst-China) Collaborative Group. Arch Intern Med 2000; 160: 211–20PubMed

107.

United Kingdom Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovaskular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317: 703–13

108.

United Kingdom Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS39. BMJ 1998; 317: 713–20

109.

Lindholm L, Ibsen H, Dahlof B, et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention for Endpoint reduction in hypertension (LIFE) study: a randomised trial against atenolol. Lancet 2002; 359: 1004–10PubMed

110.

Tuomilehto J, Rastenyte D, Birkenhager WH, et al. for the Systolic Hypertension in Europe Trial Investigators. Effects of calcium-channel blockade in older patients with diabetes and systolic hypertension. N Engl J Med 1999; 340: 677–84PubMed

111.

Hansson L, Hedner T, Lund-Johansen P, et al. Randomised trial of effects of calcium antagonists compared with diuretics and β-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 2000; 354: 1751–6

112.

Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345: 861–9PubMed

113.

Sixth report of the Joint National Committee on prevention, Detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997; 157: 2413–46

114.

Joint British recommendations on prevention of coronary heart disease in clinical practice: summary. BMJ 2000; 320: 705-8

115.

Wood D, Backer GD, Faergeman O, et al. Prevention of coronary heart disease in clinical practice: recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention. Eur Heart J 1998; 19: 1434–503

116.

Guidelines Subcommittee World Health Organization. International Society of Hypertension guidelines for the management of hypertension. J. Hypertens 1999; 17: 151–83

117.

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560–72

118.

2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension — guidelines committee. J Hyperten 2003; 21: 1011-53

119.

Pyorala K, Pedersen TR, Kjekshus J, et al. Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease: a subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care 1997; 20: 614–20PubMed

120.

Goldberg RB, Mellies MJ, Sacks FM, et al. for the CARE Investigators. Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the cholesterol and recurrent events (CARE) trial. Circulation 1998; 98: 2513–9PubMed

121.

Long-term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349–57

122.

Elkeles R, Diamond J, Poulter C, et al. Cardiovascular outcomes in type 2 diabetes: a double-blind placebo-controlled study of bezafibrate: the St. Mary’s, Ealing, Northwick Park Diabetes Cardiovascular Disease Prevention (SENDCAP) Study. Diabetes Care 1998; 21: 641–8PubMed

123.

Koskinen P, Manttari M, Manninen V, et al. Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study. Diabetes Care 1992; 15: 820–5PubMed

124.

Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002; 360: 7–22

125.

Rubins H, Robins S, Collins D, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. N Engl J Med 1999; 341: 410–8PubMed

126.

Serruys PW, de Feyter P, Macaya C, et al. Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention: a randomized controlled trial. JAMA 2002; 287: 3215–22PubMed

127.

Armitage J, Collins R. Need for a large scale randomised evidence about lowering LDL cholesterol in people with diabetes mellitus: MRC/BHF heart protection study and other major trials. Heart 2000; 84: 357–360PubMed

128.

Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324: 71–86

129.

ETDRS Investigators. Aspirin effects on mortality and morbidity in patients with diabetes mellitus: Early Treatment Diabetic Retinopathy Study report 14. JAMA 1992; 268: 1292–300

130.

Kahn CR, Chen L, Cohen SE. Unraveling the mechanism of action of thiazolidinediones. J Clin Invest 2000; 106: 1305–7PubMed

131.

Hsueh WA, Jackson S, Law RE. Control of vascular cell proliferation and migration by PPAR-gamma: a new approach to the macrovascular complications of diabetes. Diabetes Care 2001; 24: 392–7PubMed

132.

Aronoff S, Rosenblatt S, Braithwaite S, et al. Pioglitazone hydrochloride monotherapy improves glycemic control in the treatment of patients with type 2 diabetes: a 6-month randomized placebo-controlled dose-response study. The Pioglitazone 001 Study Group. Diabetes Care 2000; 23: 1605–11PubMed

133.

Wolffenbuttel BH, Gomis R, Squatrito S, et al. Addition of low-dose rosiglitazone to sulphonylurea therapy improves glycaemic control in Type 2 diabetic patients. Diabet Med 2000; 17: 40–7PubMed

134.

Neve BP, Fruchart JC, Staels B. Role of the peroxisome proliferator-activated receptors (PPAR) in atherosclerosis. Biochem Pharmacol 2000; 60: 1245–50PubMed

135.

King AB. A comparison in a clinical setting of the efficacy and side effects of three thiazolidinediones [letter]. Diabetes Care 2000; 23: 557PubMed

136.

Parulkar AA, Pendergrass ML, Granda-Ayala R, et al. Nonhypoglycemic effects of thiazolidinediones. Ann Intern Med 2001; 134: 61–71PubMed

137.

Koshiyama H, Shimono D, Kuwamura N, et al. Rapid communication: inhibitory effect of pioglitazone on carotid arterial wall thickness in type 2 diabetes. J Clin Endocrinol Metab 2001; 86: 3452–6PubMed

138.

Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 1998; 280: 605–13PubMed

139.

Writing Group for the Women’s Health Initiative I. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002; 288: 321–33

140.

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–97

141.

Yudkin JS, Chaturvedi N. Developing risk stratification charts for diabetic and nondiabetic subjects. Diabet Med 1999; 16: 219–27PubMed

Title: Preventing Macrovascular Disease in Patients with Type 2 Diabetes Mellitus
Authors: Odd E. Johansen
Kåre I. Birkeland
Publication date: 01-07-2003
Publisher: Springer International Publishing
Published in: American Journal of Cardiovascular Drugs / Issue 4/2003
Print ISSN: 1175-3277
Electronic ISSN: 1179-187X
DOI: https://doi.org/10.2165/00129784-200303040-00007

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preventing Macrovascular Disease in Patients with Type 2 Diabetes Mellitus

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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