[Early diabetic nephropathy and cardiovascular disease in a Mediterranean population: risk factors and treatment...

The objective of this cross-sectional study was to evaluate the impact of early diabetic nephropathy on the presence of cardiovascular disease (CVD) in a Mediterranean population, as well as the prevalence in these patients of traditional cardiovascular risk factors and its treatment intensity in accordance with international recommendations. In 123 patients with type 2 diabetes and incipient nephropathy the presence of CVD, smoking, hypertension, dyslipemia, and their treatment was recorded. CVD prevalence was 34%. Age, nephropathy stage (micro/macroalbuminuria), and smoking were associated with the presence of CVD. Hypertension, dyslipemia, and smoking were present in 83%, 81%, and 59%, respectively. Coexistence of several risk factors was frequent and was associated with a higher incidence of CVD. 79% hypertensive patients and 43% dyslipemic patients received pharmacological treatment but only 17% and 9%, respectively, reached a good control of their disease. Patients with known CVD showed also a deficient control. Accordingly, early diabetic nephropathy induces a multiplier effect on the cardiovascular risk of a Mediterranean population. Higher prevalence and association with cardiovascular risk factors, with smoking in a predominant role, are associated with this higher risk. Despite this, the intensity of treatment and control of these risk factors is deficient, which means that a better and more intensive treatment should reduce the morbidity and mortality in these patients.