ABSTRACT
It is timely to discuss the impact of diabetes on risk of coronary heart disease (CHD) and the measures that can be taken to reduce CHD in this high-risk population. The increase in incidence of diabetes across the world, particularly in the developing world, coupled with the two-to fourfold increase in CHD observed in diabetes has huge implications for public health. Although there is a paucity of trials so far reported in specific diabetic populations, analysis of subgroups in major CHD endpoint trials provides a reasonable evidence base for both primary and secondary CHD – although this distinction is increasingly blurred in the diabetic population. Indeed, recent guidelines from the USA have suggested that diabetes should be considered a CHD risk-equivalent.
