Affordable Access

Publisher Website

Is Hyperglycemia a Cardiovascular Risk Factor?

Diabetes Care
American Diabetes Association
Publication Date
DOI: 10.2337/dc11-s207
  • Diabetes And Cardiovascular Disease
  • Biology
  • Medicine


DC11s007 128..131 Is Hyperglycemia a Cardiovascular Risk Factor? FRANK PISTROSCH, MD1,2 ANDREA NATALI, MD3 MARKOLF HANEFELD, MD1 Patients with diabetes show an in-creased vascular morbidity andmortality that reduces their life ex- pectancy by ~5–15 years (depending on the age at diagnosis) (1). There is convinc- ing evidence from epidemiological and pathophysiological studies that hypergly- cemia per se is largely responsible for the harmful effects of the disease. As recently shown by clinical trials, treatment of this condition may reduce cardiovascular events and mortality, and several thera- pies should be considered: initiating early and individualized treatment and avoid- ing hypoglycemia. HYPERGLYCEMIA AS A CARDIOVASCULAR RISK FACTOR IN EPIDEMIOLOGICAL STUDIES—As shown in the Multiple Risk Factor Intervention Trial, at any given level of major cardiovascular risk factors, diabetes is associated with an odds ratio of 2–4 for cardiovascular mor- tality compared with nondiabetic subjects (2). These results were confirmed by the European Prospective Investigation of Cancer and Nutrition (EPIC Norfolk) study (3) and a recent analysis of the Atherosclerosis Risk in Communities (ARIC) study (4). Furthermore, a recently published 18-year follow-up study from Finland demonstrated a similar impact of type 1 and type 2 diabetes on cardiovascular mortality. The adjusted hazard ratios compared with age-matched subjects without diabetes were 5.2 and 4.9 for type 1 and type 2 diabetes, respectively (5). Thus, today evidence exists on long- term follow-up population-based studies in patients with type 1 and type 2 di- abetes. This evidence clearly suggests that hyperglycemia is a key risk factor not only for diabetes-related disease, but also for cardiovascular and all-cause mortality. On the basis of these long-term observa- tions, one can assume an increment of cardiovascular disease per increase of 1 unit (%) A1C of ~18% (6). PATHOPHYSIOLOGICAL ASPECTS OF ACUTE AND CHRONIC HYPERGLYCEM

There are no comments yet on this publication. Be the first to share your thoughts.


Seen <100 times