Diabetes: preventing coronary heart disease in a high risk group

M D Feher

Correspondence to:
Correspondence to:
Dr Michael Feher
Beta Cell Diabetes Centre and Lipid Clinic, Chelsea and Westminster Hospital, London SW10 9NH, UK; michael.feher{at}chelwest.nhs.uk

Cardiovascular disease is the major cause of morbidity and mortality in patients with type 2 diabetes. Numerous outcome trials have demonstrated clinical benefits from effective treatment of individual cardiovascular risk factors in patients with diabetes. These trials have provided the basis for current treatment guidelines and targets. More recently, multifactorial intervention strategies have shown a reduction in both cardiovascular and microvascular events in patients with type 2 diabetes. However, full implementation of a truly multifactorial strategy into routine practice remains an ideal due to practical difficulties of sustained implementation and associated costs. These practical issues relating to the treatment of diabetes and its complications are now in a greater spotlight due to the growing number of patients requiring treatment.

Keywords: diabetes; coronary heart disease; blood pressure

Abbreviations: CI, confidence interval; DCCT, diabetes control and complications trial; HDL, high density lipoprotein; HOT, hypertension optimal treatment; HR, hazard ratio; LDL, low density lipoprotein; UKPDS, UK prospective diabetes study; VA-HIT, Veterans Affairs high-density lipoprotein cholesterol intervention trial

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