Treatment of specific macrovascular beds in patients with diabetes mellitus

Abstract

In 2007, over 23 million people had diabetes in the United States and death from cardiovascular disease is estimated to occur in 80% of those Americans. Risk factor reduction is the most important therapy for primary and secondary prevention of macrovascular disease in patients with and without diabetes mellitus. Despite this, presentation and response to therapy is often different for patients with diabetes compared to their non-diabetic counterparts. This paper will review the current targets for therapy of cardiovascular disease, peripheral vascular disease, and cerebrovascular disease in patients with diabetes.

Figure 1

Ankle brachial index (ABI). Blood pressure cuffs are placed on both arms and ankles. Systolic blood pressures are measured at the brachial artery and dorsalis pedis artery with the assistance of an ultrasound Doppler. Two measurements are taken from each arm and leg and then recorded as an average. The ABI is then calculated when the systolic blood pressure in the ankle is divided by the systolic blood pressure in the arm (21).