The cardiovascular metabolic syndro...

The cardiovascular metabolic syndrome is a combination of risk factors that greatly increases the likelihood of diabetes. Diabetes is a sound risk factor for cardiovascular disease and end-stage renal disease, with cardiovascular disease being the chiefly common cause of death in bodily substances with diabetes. This risk for cardiovascular disease begins before diabetes is diagnosed, during a preceding period of increased insulin resistance and impaired diabetic sugar tolerance. Sowers reviews the usefulness of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in patients with metabolic syndrome

The Health Protection investigation looked at the effect of lowering lipids in a large cohort of bodys with type 1 and emblem 2 diabetes. After five years of treatment with simvastatin in a dosage of 40 mg there was a significant decrease in first major coronary vascular incidents in persons with no history of coronary disease and someones with prior coronary disease. These eventuates have since been confirmed with pravastatin in a dosage of 40 mg and gemfibrozil in a dosage of 1200 mg by day.

The dyslipidemia of bodily substances with metabolic syndrome or diabetes characteristically demonstrates small low-density lipoprotein (LDL) particles, high triglyceride flushs and low high-density lipoprotein (HDL) cholesterol plains Statin therapy reduces LDL cholesterol and triglyceride plains and may increase HDL cholesterol on a levels slightly, but the benefits of statins present the appearance to be independent of the change in lipid ingredients because improved outcomes with statin therapy may be noted as quickly as four months after initiation of therapy. Statins may have a direct positive consequence on vascular walls through an improvement of endothelial function, anti-inflammatory and antithrombotic actions, and attenuation of atherogenesis. Simvastatin increases endothelial nitric oxide production and improves nitric oxide-dependent vasorelaxation. Statins also bring to plasma levels of C-reactive protein and cytokines independently of reduction in LDL cholesterol flushs and increase levels of natural antioxidants.

Statins decrease fibrinogen horizontals decrease blood viscosity, and curtail platelet aggregation and adhesion. The author judges that statins have direct beneficial purports on vasculature independent of LDL cholesterol lowering. These general intents likely contribute to the decrease in cardiovascular disease and afflictions in persons with diabetes who are treated with statins.

Sowers JR consequences of statins on the vasculature: implications for aggressive lipid management in the cardiovascular metabolic syndrome Am J Cardiol February 20 2003; 91(suppl):14B-22B

COPYRIGHT 2003 American Academy of Family Physicians

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