2007 ESH‐ESC Guidelines for the management of arterial hypertension (original) (raw)
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The first-degree relatives (FDRs) of persons with type 2 diabetes mellitus have been reported to have higher risk of developing insulin resistance and diabetes than the general population. 1,2 There are also reports of increased cardiovascular (CV) risks and prevalence of CV diseases in this high-risk population. The pathophysiologic mechanisms that predispose these high-risk subjects to CV risks have not been precisely elucidated. Recently we have reported the contribution of sympathovagal imbalance (SVI) to CV risks in FDRs of type 2 diabetics. 5 Previous reports indicate sex difference in pathophysiology, clinical characteristics, severity, and vulnerability to complication in diabetes. Our report suggests significant alteration in energy homeostasis and increased susceptibility to insulin resistance in male rats compared with female rats after ventromedial hypothalamus lesion obesity. 10 There are reports of sexual dimorphism in glucose metabolism, insulin sensitivity, and insulin resistance. There is also report of sex difference in CV risks, with men more susceptible to CV diseases. 14 It was reported that sex difference in incidence of CV disease background Although cardiovascular (CV) risks are reported in first-degree relatives (FDRs) of type 2 diabetics, effects of gender on sympathovagal imbalance (SVI) and CV risks in these subjects have not been investigated.
2012
Cardiovascular disease, Type 2 diabetes and hypertension in adults CASE MANAGEMENT DESK GUIDE Evidence document Generic version May 2012 Evidence level Rationale High Further research is very unlikely to change confidence in the estimate of effect. Moderate Further research is likely to have an important impact on confidence in the effect. Low Further research is very likely to have an estimate of effect and is likely to change the estimate. Very low Any estimate of effect is very uncertain. (WHO 2010a) Limitations of evidence review: The recommendations made in the generic desk guide are based on available literature and current guidelines. Whilst every attempt has been made to perform a thorough literature search to identify appropriate and relevant evidence, it is not a fully systematic literature review, therefore it cannot be guaranteed that all available evidence has been considered. However, the recommendations also incorporate internationally approved evidence-based guidelines. These have used equivalent evidence scoring systems, thus it can be assumed that the grading of the recommendations made here is valid.