Chapter 25. Cardiac Complications and Management

  1. R. Williams4,
  2. W. Herman5,
  3. A.-L. Kinmonth7 and
  4. N. J. Wareham6
  1. Aman Chugh1,
  2. Kim A. Eagle2 and
  3. Rajendra H. Mehta3

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch25

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Chugh, A., Eagle, K. A. and Mehta, R. H. (2003) Cardiac Complications and Management, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch25

Editor Information

  1. 4

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 5

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 6

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 7

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. 1

    1500 East Medical Center Drive, Division of Cardiology, Level B1, Ann Arbor, Michigan 48109, USA

  2. 2

    University Hospital, 1500 E Medical Center Drive, 3910 Taubman Center, Box 0366, Ann Arbor, MI 48109-0366, USA

  3. 3

    Department of Internal Medicine, Division of Cardiology, Veterans Hospital, 1215 Fuller Road 111A, 7E Ann Arbor, MI 48105, USA

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582



  • coronary artery disease;
  • cardiomyopathy;
  • risk factor;
  • congestive heart failure;
  • diagnosis;
  • antiplatelet agent;
  • beta-blocker;
  • angiotensin converting enzyme inhibitor;
  • hypertension;
  • glycemic control;
  • reperfusion therapy;
  • coronary revasularization


Evidence from a variety of epidemiological studies indicates that patients with diabetes are at high risk for cardiac disorders: coronary artery disease, cardiomyopathy and congestive heart failure. Risk factors for coronary artery disease that exist simultaneously with diabetes may be hereditary, advanced age, sex, obesity and lack of physical exercise. Patients with diabetes have elevated whole plasma and blood viscosity owing to high levels of plasma proteins, increased red cell aggregation and decreased red cell deformity, which probably contribute to the extension of infarction. Both type 1 and type 2 diabetes are independent risk factors for coronary heart disease. Patients with diabetes are unusually prone to enhanced myocardial dysfunction leading to accelerated heart failure; they are also predisposed to early development of cardiac autonomic neuropathy. Early diagnosis of coronary artery disease is imperative. The lack of typical symptoms makes this difficult and requires a high index of suspicion in physicians. Management options include antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors, control of high blood pressure, control of hyperglycemia, reperfusion therapy and coronary revascularization.