Diabetes Mellitus and Noncardiac Atherosclerotic Vascular Disease-Pathogenesis and Pharmacological Treatment Options

J Cardiovasc Pharmacol Ther. 2021 Jan;26(1):25-39. doi: 10.1177/1074248420941675. Epub 2020 Jul 15.

Abstract

Diabetes mellitus (DM) is also a cause of cardiovascular (CV) disease (CVD). Addressing the atherosclerotic CVD (ASCVD) burden in DM should reduce premature death and improve quality of life. Diabetes mellitus-associated ASCVD can lead to complications in all vascular beds (carotids as well as coronary, lower extremity, and renal arteries). This narrative review considers the diagnosis and pharmacological treatment of noncardiac atherosclerotic vascular disease (mainly in patients with DM). Based on current knowledge and the fact that modern DM treatment guidelines are based on CV outcome trials, it should be noted that patients with noncardiac CVD may not have the same benefits from certain drugs compared with patients who predominantly have cardiac complications. This leads to the conclusion that in the future, consideration should be given to conducting well-designed trials that will answer which pharmacological treatment modalities will be of greatest benefit to patients with noncardiac ASCVD.

Keywords: aortic aneurysm; cardiovascular outcome trials; diabetes mellitus; noncardiac atherosclerotic vascular disease; peripheral artery disease; pharmacological treatment; renal artery stenosis; stroke.

Publication types

  • Review

MeSH terms

  • Animals
  • Aortic Aneurysm / diagnosis
  • Aortic Aneurysm / drug therapy*
  • Aortic Aneurysm / epidemiology
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / drug therapy*
  • Peripheral Arterial Disease / epidemiology
  • Renal Artery Obstruction / diagnosis
  • Renal Artery Obstruction / drug therapy*
  • Renal Artery Obstruction / epidemiology
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / drug therapy*
  • Stroke / epidemiology
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Hypoglycemic Agents