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International Journal of Hypertension
Volume 2013, Article ID 653789, 15 pages
Review Article

Impact of Diabetes on Cardiovascular Disease: An Update

1Department of Internal Medicine, Diabetes Unit, State University of Rio de Janeiro, Avenida 28 de Setembro 77, Terceiro Andar, Vila Isabel, 20551-030 Rio de Janeiro, RJ, Brazil
2Department of Internal Medicine, Bauru's Diabetics Association, Rua Saint Martin 27-07, 17.012-433 Bauru, SP, Brazil

Received 6 December 2012; Revised 31 January 2013; Accepted 31 January 2013

Academic Editor: Mario Fritsch Neves

Copyright © 2013 Alessandra Saldanha de Mattos Matheus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cardiovascular diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. Recently, epigenetic factors by different types of reactions are known to be responsible for the interaction between genes and environment and for this reason can also account for the association between diabetes and cardiovascular disease. The impact of clinical factors that may coexist with diabetes such as obesity, dyslipidemia, and hypertension are also discussed. Furthermore, evidence that justify screening for subclinical atherosclerosis in asymptomatic patients is controversial and is also matter of this review. The purpose of this paper is to describe the association between poor glycemic control, oxidative stress, markers of insulin resistance, and of low-grade inflammation that have been suggested as putative factors linking diabetes and cardiovascular disease.