Traditional Cardiovascular Risk Factors

Hypertension, dyslipidemia, obesity and smoking, that is, the classic cardiovascular risk factors, each contribute to the risk profile in the patient with type 2 DM.

Blood pressure

Hypertension develops in about half of the patients with type 2 DM. This is important, not only because increased systemic blood pressure is a cardiovascular risk factor, but also because of the association between hypertension and accerated renal function loss. Moreover, effective blood pressure control is associated with a slower disease progression, possibly because of a concomitant amelioration of intracapillary hypertension and protein ultrafiltration in the kidneys. Thus, patients in the IDNT who had lower systolic blood pressure levels during treatment also had a markedly lower risk to reach a renal endpoint [28]. Although the study was not designed to compare the renal effects of different levels of achieved blood pressure control, the findings do favour an important effect of lowering systolic blood pressure in macroalbuminuric type 2 diabetic patients, at least to 130 mm Hg -and possibly lower.

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