Risk Factors for Coronary Heart Disease in Diabetes
Authors: Vivian Andrew Fonseca
Journal: Annals of Internal Medicine (2000)

Editorials18 July 2000Risk Factors for Coronary Heart Disease in DiabetesVivian Andrew Fonseca, MD, MRCPVivian Andrew Fonseca, MD, MRCPTulane University Medical Center; New Orleans, LA 70112 (Fonseca)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-2-200007180-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Persons with diabetes are disproportionately affected by coronary heart disease. Furthermore, diabetic patients have not benefited from the advances in the management of coronary heart disease or its risk factors, which have decreased mortality from coronary heart disease in persons without diabetes (1). Some of the excess risk in persons with diabetes is related to an increased prevalence of established risk factors, such as obesity, dyslipidemia, and hypertension. Nevertheless, traditional risk factors do not fully explain the excess risk for coronary heart disease in these persons (2). Therefore, other, "nontraditional" risk factors may be important in diabetes.In this issue, ...References1. Gu K, Cowie CC, Harris MI. Diabetes and decline in heart disease mortality in US adults. JAMA. 1999;281:1291-7. CrossrefMedlineGoogle Scholar2. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16:434-44. CrossrefMedlineGoogle Scholar3. Saito I, Folsom AR, Brancati FL, Duncan BB, Chambless LE, McGovern PG. Nontraditional risk factors for coronary heart disease incidence among persons with diabetes: The Atherosclerosis Risk in Communities (ARIC) Study. Ann Intern Med. 2000;133:81-9. LinkGoogle Scholar4. Ceriello A. Fibrinogen and diabetes mellitus: is it time for intervention trials? Diabetologia. 1997;40:731-4. CrossrefMedlineGoogle Scholar5. Fernandez-Real JM, Ricart W. Insulin resistance and inflammation in an evolutionary perspective: the contribution of cytokine genotype/phenotype to thriftiness. Diabetologia. 1999;42:1367-74. CrossrefMedlineGoogle Scholar6. Hak AE, Stehouwer CD, Bots ML, Polderman KH, Schalkwijk CG, Westendorp IC, et al . Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women. Arterioscler Thromb Vasc Biol. 1999;19:1986-91. CrossrefMedlineGoogle Scholar7. Stern MP. Diabetes and cardiovascular disease. The "common soil" hypothesis. Diabetes. 1995;44:369-74. CrossrefMedlineGoogle Scholar8. Malmberg K. Prospective randomized 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;314:1512-5. CrossrefMedlineGoogle Scholar9. UK Prospective Diabetes Study (UKPDS) 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. CrossrefMedlineGoogle Scholar10. Lormeau B, Aurousseau MH, Valensi P, Paries J, Attali JR. Hyperinsulinemia and hypofibrinolysis: effects of short-term optimized glycemic control with continuous insulin infusion in type II diabetic patients. Metabolism. 1997;46:1074-9. CrossrefMedlineGoogle Scholar11. Stehouwer CD, Nauta JJ, Zeldenrust GC, Hackeng WH, Donker AJ, den Ottolander GJ. Urinary albumin excretion, cardiovascular disease, and endothelial dysfunction in non–insulin-dependent diabetes mellitus. Lancet. 1992;340:319-23. CrossrefMedlineGoogle Scholar12. Juhan-Vague I, Alessi MC. PAI-1, obesity, insulin resistance and risk of cardiovascular events. Thromb Haemost. 1997;78:656-60. CrossrefMedlineGoogle Scholar13. Fonseca VA, Reynolds T, Hemphill D, Randolph C, Wall J, Valiquet TR, et al . Effect of troglitazone on fibrinolysis and activated coagulation in patients with non–insulin-dependent diabetes mellitus. J Diabetes Complications. 1998;12:181-6. CrossrefMedlineGoogle Scholar14. Nagi DK, Yudkin JS. Effects of metformin on insulin resistance, risk factors for cardiovascular disease, and plasminogen activator inhibitor in NIDDM subjects. A study of two ethnic groups. Diabetes Care. 1993;16:621-9. CrossrefMedlineGoogle Scholar15. Stehouwer CD, Gall MA, Hougaard P, Jakobs C, Parving HH. Plasma homocysteine concentrations predict mortality in non–insulin-dependent diabetic patients with and without albuminuria. Kidney Int. 1999;55:308-14. CrossrefMedlineGoogle Scholar16. Munshi MN, Stone A, Fink L, Fonseca V. Hyperhomocysteinemia following a methionine load in patients with non–insulin-dependent diabetes mellitus and macrovascular disease. Metabolism. 1996;45:133-5. CrossrefMedlineGoogle Scholar17. Gillum RF, Mussolino ME, Madans JH. Coronary heart disease incidence and survival in African-American women and men. The NHANES I Epidemiologic Follow-up Study. Ann Intern Med. 1997;127:111-8. LinkGoogle Scholar18. Ridker PM, Rifai N, Pfeffer MA, Sacks F, Braunwald E. Long-term effects of pravastatin on plasma concentration of C-reactive protein. The Cholesterol and Recurrent Events (CARE) Investigators. Circulation. 1999;100:230-5. CrossrefMedlineGoogle Scholar19. Colwell JA. Aspirin therapy in diabetes. Diabetes Care. 1997;20:1767-71. CrossrefMedlineGoogle Scholar20. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336:973-9. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Tulane University Medical Center; New Orleans, LA 70112 (Fonseca)Corresponding Author: Vivian Andrew Fonseca, MD, MRCP, Section of Endocrinology, Tulane University Medical Center, 1430 Tulane Avenue (SL 53), New Orleans, LA 70112; e-mail, [email protected]tcs.tulane.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNontraditional Risk Factors for Coronary Heart Disease Incidence among Persons with Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study Isao Saito , Aaron R. Folsom , Frederick L. Brancati , Bruce B. Duncan , Lloyd E. Chambless , and Paul G. 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Rathore, MPH, Paul Frame, MD, Steven H. Woolf, MD, MPH, and Kathleen N. Lohr, PhDDiabetes and other coronary heart disease risk equivalentsEmerging concepts in metabolic abnormalities associated with coronary artery diseaseSexual Dysfunction and Cardiovascular Risk – Links and Solutions 18 July 2000Volume 133, Issue 2Page: 154-156KeywordsAlbuminsCoronary heart diseaseFibrinogenInflammationInsulinInsulin resistanceLongitudinal studiesMedical risk factorsMicroalbuminuriaType 2 diabetes Issue Published: 18 July 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...