Assessing cardiovascular risk in patients with diabetes: An update.
The globalization of the Western lifestyle has resulted in a dramatic increase of diabetes mellitus, a complex, multifactorial disease. Diabetes mellitus is a condition often associated with disorders of the cardiovascular system. It is well established that three quarters of diabetics, aged over 40, will die from cardiovascular disease and are more likely than non-diabetics to die from their first cardiovascular event. Therefore, risk stratification is necessary to individualize treatment. Age above 40 years, diabetes diagnosis of more than 10 years, the presence of a first degree family history with premature CHD, male gender, high blood pressure, LDL above 100 mg/dl, low renal function, microalbuminuria, presence of non-alcoholic fatty liver disease, obstructive sleep apnea, erectile dysfunction and specially metabolic syndrome, chronic hyperglycemia and severe hypoglycemia are conditions that increase cardiovascular risk. Several models have been developed in order to assess cardiovascular risk in people with and without diabetes. Some of them have been proven to be inadequate while others are widely used for years. An emerging way of risk assessment in patients with diabetes mellitus is the use of biomarkers but a lot of research needs to be done on this field in order to have solid conclusions.