• Hoong Sern Lim, Robert J MacFadyen, George Bakris, and Gregory Y H Lip.
• Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, England.
• Curr. Pharm. Des. 2006 Jan 1;12(13):1567-79.

AbstractPopulation studies have identified diabetes mellitus as a risk factor for cardiac and vascular events, with a common association with hypertension. Observational studies have consistently demonstrated blood glucose as a continuous cardiovascular risk factor. Experimental studies suggest that elevated blood glucose, through a range of biochemical pathways can promote atherogenesis and increase the tendency for thrombosis. The resultant state promotes occlusion of arterial flow and increase cardiovascular event rates. However, an unconvincing temporal relationship (raised blood glucose preceding cardiovascular events) and the limited impact of glucose reduction in patients with diabetes on cardiovascular events do not support blood glucose as a major cause of cardiovascular disease. In this review, we discuss the relationship between hyperglycaemia and a hypercoagulable state in diabetes and the implications of this relationship for the treatment of patients with diabetes, who also commonly have hypertension.

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