Background: To examine the relationship of non-insulin dependent diabetes mellitus (NIDDM) with the prevalence of coronary heart disease (CHD) in a hospitalized population.
Methods and results: Diabetes was associated with a markedly increased risk of developing CHD, whose prevalence was of 48.3% in NIDDM subjects (528 males and 661 females). Between the two groups (with and without CHD) of diabetic patients, the mean age was higher in the CHD-group, but no differences were noted with regard to gender distribution, BMI, history of cigarette smoking, alcohol consumption, glycemic control, hypoglycemic treatment, lipid pattern (although a slight increase in mean level of serum total triglycerides was observed in NIDDM subjects with CHD). On the contrary, CHD was significantly associated with a higher prevalence of periferal vascular disease (49.3% vs 32.5%) and with hypertension and renal dysfunction.
Conclusions: These observations support the evidence that diabetes exerts a deleterious effect on general risk factors of atherosclerosis and increases the susceptibility to cardiovascular disease, although the prevalent mechanism of this susceptibility is only partly explained. Because the adverse "independent" effect of diabetes on the risk of cardiovascular disease is amplified in the presence of other cardiovascular risk factors, these data underscore the importance of prevention of diabetes and, once diabetes is clinically established, the need for standard risk factors management (hypertension, obesity, elevated lipid levels) as well as the development of new therapeutic strategies, in order to reduce the progress of macrovascular disease and the hemostatic derangements which may predispose to thrombosis and endothelial cell injury.