Атеросклероз (Dec 2011)
Diabetes mellitus and coronary atherosclerosis
Abstract
Diabetic patients have the excess risk of developing atherosclerotic coronary artery disease (CAD), which is the most common cause of death in diabetes. The major contributor to the increased CAD risk in patients with type 2 diabetes is dyslipidemia. The multicomponent pathogenesis of accelerated coronary atherosclerosis in diabetes remains incompletely understood. At present there is not convincing evidence of intensive glucose control benefit for prevention cardiovascular complications of diabetes. Low-density lipoprotein cholesterol is recognized as the primary target of the treatment of dyslipidemia in diabetic patients and statins are the drugs of choice for lowering low-density lipoprotein cholesterol. In patients with diabetes and hypertension the main determinant of the cardiovascular benefits of antihypertensive drugs is the blood pressure level achieved under treatment, but nevertheless pharmacologic therapy should include either an angiotensin-converting enzyme inhibitors or an angiotensin II receptor antagonist.