Review article
Metabolic Insulin Resistance and Cardiovascular System
Mirjana Jembrek-Gostović
Inge Heim
Vladimir Jonke
Mladen Gostović
Dubravka Kruhek-Leontić
Abstract
Cardiovascular diseases (CVD) represent
the major cause of premature death in most developed
countries and in Croatia as well. They also largely
contribute to a diminished work capacity and escalating
healthcare costs. The basic pathology is atherosclerosis
that develops insidiously over many years. Sudden cardiac
death, myocardial infarction and stroke are only the fi nal
episodes in this process. As they usually occur abruptly,
many therapeutic interventions are only palliative. The
mass occurrence of CVD is strongly related to lifestyle
and physiological risk factors. It has been unequivocally
proven that the risk factor modifi cation reduces morbidity
and mortality in people with established and unestablished
CVD. CVD is generally caused by a combination of several
risk factors. The European Guidelines on CVD Prevention
in Clinical Practice (2003), which were accepted by
the Croatian Cardiac Society and some other related
societies in 2004, recommend a total CV risk estimation
as a guide to preventive strategies (the SCORE system).
Some combinations of atherogenic risk factors increase
the total risk for the development of CVD more than other
combinations or single risk factors. The combination of
hyperglycaemia, hypertension, hyperlipoproteinaemia and
central obesity, associated with insulin resistance, is known
as the metabolic syndrome (syndrome X) that, according to
the European guidelines, represents a particularly high CVD
risk. The aim in the prevention of CVD morbidity and mortality
is an early detection of risk factors (primary prevention) and
the treatment of single risk factors along with the slowing
down of atherosclerosis (secondary prevention).
Keywords
cardiovascular diseases; atherosclerosis; metabolic syndrome; prevention; treatment
Hrčak ID:
18995
URI
Publication date:
15.11.2004.
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