Macrovascular complications Flashcards
examples of macrovascular disease?
Early widespread atherosclerosis
Ischaemic heart disease
Cerebrovascular disease
Peripheral vascular disease
what factors increase the risk of atherosclerosis?
hyperglycaemia low HDL hypertension Insulin resistance adipocytokines large waist circumference
progression of endothelial dysfunction
initial lesion fatty streak intermediate lesion atheroma fibroatheroma complicated lesion
what’s the correlation between hyperglycaemia and life expectancy
Hyperglycaemia is associated with significantly reduced life expectancy
what causes morbidity and what causes morbidity and mortality
Microvascular disease causes morbidity; macrovascular disease causes morbidity and mortality
where is macrovascular disease commonly present?
Macrovascular Disease is a systemic disease and is commonly present in multiple arterial beds
what is ischaemia heart disease?
The major cause of morbidity and mortality in diabetes
The mechanisms are similar with and without diabetes
what is cerebrovascular disease?
Earlier than without diabetes
More widespread
what does peripheral vascular disease lead to?
Contributes to diabetic foot problems with neuropathy
what does renal artery stenosis contribute to?
May contribute to hypertension and renal failure
what effect does control of hyperglycaemia have on CVDs?
Treatment targeted to hyperglycaemia alone has minor effect on increased risk of cardiovascular disease
what are the non-modifiable risk factors for macrovascular disease?
Age
Sex
Birth weight
FH/Genes
what are the modifiable risk factors for macrovascular disease?
Dyslipidaemia
High blood pressure
Smoking
Diabetes
what does canakinumab do?
Reduces inflammation, without [lipid] Monoclonal Ab targets interleukin-1Β N=10,061, median 3.7yr previous MI and CRP>2 HbA1c lower 0.85 (0.74-0.98) lower risk recurrent cardiovascular events Higher risk infection
