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Inicio Endocrinología y Nutrición Morbimortalidad por cardiopatía isquémica en el paciente diabético
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Vol. 53. Núm. 6.
Páginas 405-417 (junio 2006)
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Vol. 53. Núm. 6.
Páginas 405-417 (junio 2006)
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Morbimortalidad por cardiopatía isquémica en el paciente diabético
Morbidity and mortality from ischemic heart disease in diabetic patients
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4348
Eduardo Esteve
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uden.eesteve@htrueta.scs.es

Correspondencia: Dr. E. Esteve Lafuente.Unidad de Diabetes, Endocrinología y Nutrición Territorial de Girona.Hospital Universitario de Girona Dr. Josep Trueta.Ctra. de França, s/n. 17007 Girona. España.
, Wifredo Ricart
Unidad de Diabetes, Endocrinología y Nutrición Territorial de Girona. Hospital Universitario de Girona Doctor Josep Trueta.Girona. España
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La enfermedad cardiovascular es la causa más importante de mortalidad en los pacientes diabéticos. Tanto la hiperglucemia per se como la acumulación de otros factores de riesgo cardiovascular hacen que los sujetos diabéticos tengan un riesgo coronario significativamente superior al de la población general. En los últimos años se han publicado diferentes estudios de intervención tanto en pacientes diabéticos como en subgrupos de sujetos diabéticos de la población general sobre el control de factores de riesgo como la hipertensión,la microalbuminuria, la dislipemia, la inflamación, la agregación plaquetaria y la hiperglucemia. El efecto beneficioso observado al actuar en los diferentes factores de riesgo lleva a la conclusión de que el tratamiento de los pacientes diabéticos debe ser multidisciplinario.Hace 15 años, en la Declaración de Sant Vincent se establecieron las guías internacionales que instaban a controlar todos los factores de riesgo cardiovascular en el paciente diabético con el objetivo de reducer la elevada mortalidad cardiovascular que estos pacientes presentaban.Desde su publicación, la evolución de la mortalidad cardiovascular en los sujetos diabéticos parece haber sido positiva, aunque no se haya conseguido igualar el riesgo de estos pacientes al de la población general.

Palabras clave:
Diabetes
Factores de riesgo cardiovascular
Infarto de miocardio
Enfermedad cardiovascular

Cardiovascular disease is the most important cause of death in diabetic patients. Both hyperglycemia per se and the clustering of other cardiovascular risk factors significantly increase the risk for coronary heart disease in diabetic patients over that found in the general population.In the last few years, interventional studies have been reported on the management of cardiovascular risk factors such as hypertension, microalbuminuria, dyslipidemia, inflammation, platelet aggregation and hyperglycemia in both diabetic patients and in selected diabetic subjects from the general population or population-based studies. The beneficial effects of treating these cardiovascular risk factors have led to the belief that the therapeutic approach to diabetic patients should be multidisciplinary. Fifteen years ago, the international guidelines of the Declaration of Saint Vincent for the control of cardiovascular risk factors in diabetic patients were established to reduce the increased mortality in these subjects.Cardiovascular mortality trends after this declaration seem to have improved in diabetic subjects but have not reached those in the general population.

Key words:
Diabetes
Cardiovascular risk factors
Myocardial infarction
Cardiovascular disease
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