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A Pathophysiological Approach of Macrovascular Complication in Diabetes Mellitus with Hypertension:A Systematic Review


Affiliations
1 Department of Pharmacy Practice, JKK Nattraja College of Pharmacy, Komarapalayam, Namakkal (Dist), Tamil Nadu - 638183, India
2 Department of Pharmacology, JKK Nattraja College of Pharmacy, Komarapalayam, Namakkal (Dist), Tamil Nadu - 638183, India
     

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Type 2 Diabetes mellitus (DM) is a common metabolic disorder characterized by hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. The term Metabolic Syndrome describes the clustering of these conditions. The lipid abnormalities are prevalent in DM because insulin resistance or deficiency affects key enzymes and pathways in lipid metabolism. The altered metabolisms of carbohydrate, lipid and protein play a role in diabetic complications like hypercholesterolemia and hypertriglyceridemia, because of this hyperlipidemia in type 2 DM having the diabetic complication. The traditional risk factors that are associated with coronary artery disease (CAD) in the general population including obesity, physical inactivity, hypertension (HT), and dyslipidemia are prevalent in the diabetic population. Persons with diabetes tend to have a clustering of these risk factors in what is termed the metabolic syndrome hence multiplying their overall risk. Obesity increases the risk of CAD in adults and has been strongly associated with insulin resistance in normoglycemic persons and in individuals with type 2 DM.

Keywords

Diabetes Mellitus, Hypertension, Coronary Artery Disease, Obesity, Macro Vascular Complication.
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  • King RA, Rotter JI, Motulsky AG. The genetic basis of common diseases. Oxford: Oxford University Press; American Journal of Medical Genetics. 1992; p. 326-348.

  • Fraser FC. Evolution of a palatable multifactorial threshold model. The American journal of human genetics.1980; 32:796–813.

  • Yoon KH, Lee JH, Kim JW, et al. Epidemic obesity and type 2 diabetes in Asia. Lancet. 2006; 368:1681–1688.

  • Muntzel MS, Anderson EA, Johnson AK, Mark AL. Mechanisms of insulin action on sympathetic nerve activity, Clinical and Experimental Hypertension. 1995; 17: 39–50.

  • Cipollone F, Iezzi A, Fazia M, et al. The receptor RAGE as a progression factor amplifying arachidonate-dependent inflammatory and proteolytic response in human atherosclerotic plaques: role of glycemic control. Circulation. 2003; 108: 1070-1177.

  • Chan JCN, Malik V, Jia W, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. The Journal of the American College of Cardiology. 2009; 301:2129–2140.

  • Cardillo C, Campia U, Bryant MB, Panza JA. Increased activity of endogenous endothelin in patients with type 2 diabetes mellitus. Circulation. 2002; 106: 1783-1787.

  • Devereux RB, Roman MJ, Paranicas M, et al. Impact of diabetes on cardiac structure and function: the Strong Heart Study. Circulation. 2000; 101: 2271-6.

  • Nathan DM. Long-term complications of diabetes mellitus. The New England Journal of Medicine. 1993; 328: 1676-1685.

  • Liu JE, Palmieri V, Roman MJ, et al. The impact of diabetes on left ventricular filling pattern in normotensive and hypertensive adults: the Strong Heart Study. The Journal of the American College of Cardiology. 2001; 37: 1943-1949.

  • D’Souza A, Hussain, MF, Howarth, CN, Woods M, Bidasee K, Singh J, Pathogenesis and pathophysiology of accelerated atherosclerosis in the diabetic heart, Molecularand Cellular Biochemistry. 2009; 331:89–116.

  • Mohd. Yaqub Khan, Poonam Gupta, BipinBihari, Vikas Kumar Verma. A Review on Diabetes and Its Management. Asian Journal of Pharmaceutical Research. 2013; 3: 27-32.

  • Schannwell CM, Schneppenheim M, Perings S, Plehn G, Strauer BE. Left ventricular diastolic dysfunction as an early manifestation of diabetic cardiomyopathy. Cardiology. 2002; 98: 33-9.

  • Moreno PR, Purushothaman KR, Fuster V, et al. Plaque neovascularization is increased in ruptured atherosclerotic lesions of human aorta: implications for plaque vulnerability, Circulation. 2004; 110:2032–2038.

  • Struthers AD, Morris AD. Screening for and treating left-ventricular abnormalities in diabetes mellitus: a new way of reducing cardiac deaths. Lancet.2002; 359: 1430-1432.

  • Bella JN, Devereux RB, Roman MJ, et al. Separate and joint effects of systemic hypertension and diabetes mellitus on left ventricular structure and function in American Indians (the Strong Heart Study). The Journal of the American College of Cardiology. 2001; 87: 1260-1265.

  • Thenmozhi. P, Sowmiya. E. A Retrospective Study: Obstructive Sleep Apnea a risk factor for Cardiovascular Disorder. Research Journal of Pharmacy and Technology. 2018; 11: 3152-3156.

  • Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis epidemiology, pathophysiology and management. The Journal of the American Medical Association. 2002; 287: 2570-2581.

  • Hadeel Thaeir Al-Najeem, Arshad Noori Ghani Al-Dujaili. Assessment of Bone Morphogentic protein receptor 2 Level in Pulmonary Arterial Hypertension Disease. Research Journal of Pharmacy and Technology. 2017; 10: 2614-2618.

  • HadeelThaeir Al-Najeem, Arshad Noori Ghani Al-Dujaili. Assessment of Gremlin-1 Level in Pulmonary arterial hypertension disease. Research Journal of Pharmacy and Technology. 2017; 10: 3803-3806.

  • Russell III RR, Yin R, Caplan MJ, et al. Additive effects of hyperinsulinemia and ischemia on myocardial GLUT1 and GLUT4 translocation in vivo. Circulation. 1998; 98: 2180-2186.

  • Radrigues B, Cam, McNeil JH. Metabolic disturbances in diabetic cardiomyopathy. Molecular and Cellular Biochemistry. 1998; 180: 53-57.

  • Herrero P, Peterson LR, McGill JB, et al. Increased myocardial fatty acid metabolism in patients with type 1 diabetes mellitus. The Journal of the American College of Cardiology. 2006; 47: 598-604.

  • Radrigues B, Cam, McNeil JH. Metabolic disturbances in diabetic cardiomyopathy. Molecula rand Cellular Biochemistry. 2000; 180: 53-57.

  • Cai L, Wang Y, Zhou G, et al. Attenuation by metallothionein of early cardiac cell death via suppression of mitochondrial oxidative stress results in a prevention of diabetic cardiomyopathy. The Journal of the American College of Cardiology. 2006; 48: 1688-1697.

  • Young ME, Mcnulty P, Taegtmeyer H. Adaptation and maladaptation of the heart in diabetes: part II potential mechanisms. Circulation. 2002; 105: 1861-1870.

  • Nitenberg A, Valersi P, Sachs R, et al. Impairment of coronary vascular reserve and Ach-induced coronary vasodilatation in diabetic patients with angiographically normal coronary arteries and normal left ventricular systolic function. Diabetes care. 1993; 42: 1017-1025.

  • Boudina S, Dale Abel E. Diabetic cardiomyopathy revisited. Circulation. 2007; 115: 3213-3223.

  • Drzewoski J. Gliclazide, inflammation and atherosclerosis. Antiinflammatory antiallergyagents The Journal of Medicinal Chemistry. 2008; 7: 224-30.

  • Chavali V, Tyagi SC, Mishra P. Predictors and prevention of diabetic cardiomyopathy. Diabetes mellitus A Metabolic Syndrome Obesity. 2013; 6: 151-60.

  • Berg TJ, Snorgaard O, Faber J, et al. Serum levels of advanced glycation end products are associated with left ventricular diastolic dysfunction in patients with diabetes. Diabetes Care. 1999; 22: 1186.

  • Arnold JM, Yusuf S, Young J, et al. HOPE Investigators. Prevention of heart failure in patients in the Heart Outcome Prevention Evaluation (HOPE) study. Circulation. 2003; 107: 1284-90.

  • Wokoma FS, Unachukwu C, Emem-Chioma P, Alasia DD. Lipid profiles of type 2 diabetic adult Nigerians. Port Harcourt Medica lJournal. 2009; 3:191-198.

  • Steinberger J, Daniels SR. Obesity, Insulin Resistance, Diabetes, and Cardiovascular Risk in Children. An American Heart Association Scientific Statement From the Atherosclerosis, Hypertension, and Obesity in the Young Committee and the Diabetes Committee. Circulation.2003; 107:1448-1453.

  • Cai L, Li W, Wang G, et al. Hyperglycaemia induced apoptosis in mouse myocardium: mitochondrial C-mediated caspase-3 activation pathway. Diabetes care.2002; 51: 1938-1948.

  • Zhi YF, Johannes BP, Marwick JH. Diabetic cardiomyopathy: evidences, mechanism and therapeutic implications. Endocrine Reviews. 2004; 25: 543-567.

  • Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. The Journal of the American Medical Association. 1979; 241: 2035-2038.

  • Bertoni AG, Tsai A, Kasper EK, Brancati FL. Diabetes and idiopathic cardiomyopathy: a nationwide case-control study. Diabetes Care 2003; 26: 2791-2795.

  • Bell DSH. Diabetic cardiomyopathy. Diabetes Care 2003; 26: 2949-2950.

  • Liu JE, Robbins DC, Palmieri V, et al. Association of albuminuria with systolic and diastolic left ventricular dysfunction in type 2 diabetes: the Strong Heart Study. The Journal of the American College of Cardiology. 2003; 42: 2022-2028.

  • G Sathyanarayanan, P. Shanmugasundaram, P. Geetha. A Prospective Observational Study on Microalbuminuria as Risk factor of Chronic Renal Failure in patients with Type 2 Diabetes. Research Journal of Pharmacy and Technology. 2017; 10: 3085-3088.

  • Kissebah AH, Krakower GR. Regional adiposity and morbidity. Physiological Reviews. 1994; 74:761-811.

  • Reaven, GM. Pathophysiology of insulin resistance in human disease. Physiological Reviews. 1995; 75:473-486.

  • Dinneen SF, Gerstein HC. The association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus: a systematic overview of the literature. Archives of Internal Medicine. 1997; 157:1413–1418.

  • Pinkney JH, Foyle WJ, Denver AE, et al. The relationship of urinary albumin excretion rate to ambulatory blood pressure and erythrocyte sodium-lithium counter transport in NIDDM. Diabetologia. 1995; 38:356–362.

  • Anand DV, Lim E, Lahiri A, Bax JJ. The role of noninvasive imaging in the risk stratification of asymptomatic diabetic subjects. The European Heart Journal. 2006; 27:905-912.

  • HinaKausar, DhekaleDilip N, Mohammed Ubaid-Ur-Rahaman. A Retrospective Study of Association of Hypertension and Socio Economic Status. Research Journal of Pharmacology and Pharmacodynamics. 2013; 5: 218-219.

  • Ranjadayalan K, Umachandran V, Ambepityia G, et al. prolonged angina perception threshold in diabetes: effects on exercise capacity and myocardial ischemia. The Journal of the American College of Cardiology.1990; 16:1120-1124.


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  • A Pathophysiological Approach of Macrovascular Complication in Diabetes Mellitus with Hypertension:A Systematic Review

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Authors

S. M. Vanmathi
Department of Pharmacy Practice, JKK Nattraja College of Pharmacy, Komarapalayam, Namakkal (Dist), Tamil Nadu - 638183, India
M. Monitha Star
Department of Pharmacy Practice, JKK Nattraja College of Pharmacy, Komarapalayam, Namakkal (Dist), Tamil Nadu - 638183, India
R. Shanmuga Sundaram
Department of Pharmacology, JKK Nattraja College of Pharmacy, Komarapalayam, Namakkal (Dist), Tamil Nadu - 638183, India
M. I. Jishala
Department of Pharmacy Practice, JKK Nattraja College of Pharmacy, Komarapalayam, Namakkal (Dist), Tamil Nadu - 638183, India

Abstract


Type 2 Diabetes mellitus (DM) is a common metabolic disorder characterized by hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. The term Metabolic Syndrome describes the clustering of these conditions. The lipid abnormalities are prevalent in DM because insulin resistance or deficiency affects key enzymes and pathways in lipid metabolism. The altered metabolisms of carbohydrate, lipid and protein play a role in diabetic complications like hypercholesterolemia and hypertriglyceridemia, because of this hyperlipidemia in type 2 DM having the diabetic complication. The traditional risk factors that are associated with coronary artery disease (CAD) in the general population including obesity, physical inactivity, hypertension (HT), and dyslipidemia are prevalent in the diabetic population. Persons with diabetes tend to have a clustering of these risk factors in what is termed the metabolic syndrome hence multiplying their overall risk. Obesity increases the risk of CAD in adults and has been strongly associated with insulin resistance in normoglycemic persons and in individuals with type 2 DM.

Keywords


Diabetes Mellitus, Hypertension, Coronary Artery Disease, Obesity, Macro Vascular Complication.

References