[The need for strict control of cardiovascular risk factors in type 2 diabetic patients]

HIGH CARDIOVASCULAR RISK: The clinical and metabolic anomalies observed in patients with type 2 diabetes are associated with high risk of cardiovascular disease (particularly coronary heart disease), which is responsible for 75% of all deaths in diabetic patients. CLASSICAL RISK FACTORS: Several large-scale surveys have demonstrated the role of classic risk factors such as hypercholesterolemia, smoking and hypertension in the development of ischemic heart disease compared with the general population. OTHER RISK FACTORS: Other risk factors in the diabetic patient include risk associated with the metabolic anomalies (blood glucose levels, insulin resistance) as well as to left ventricular hypertrophy and microalbuminuria, which are often found together in hypertensive diabetics. INTERNATIONAL GUIDELINES: The importance of these risks has led several organizations to issue guidelines, particularly regarding the need for stricter blood pressure control. Regular screening for microalbuminuria and renal dysfunction (creatinine clearance) is also recommended, as well as more rigorous objectives for lipid levels.