A Pathophysiological Approach of Macrovascular Complication in Diabetes Mellitus with Hypertension: A Systematic Review

Type 2 Diabetes mellitus (DM) is a common metabolic disorder characterized by hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. The term Metabolic Syndrome describes the clustering of these conditions. The lipid abnormalities are prevalent in DM because insulin resistance or deficiency affects key enzymes and pathways in lipid metabolism. The altered metabolisms of carbohydrate, lipid and protein play a role in diabetic complications like hypercholesterolemia and hypertriglyceridemia, because of this hyperlipidemia in type 2 DM having the diabetic complication. The traditional risk factors that are associated with coronary artery disease (CAD) in the general population including obesity, physical inactivity, hypertension (HT), and dyslipidemia are prevalent in the diabetic population. Persons with diabetes tend to have a clustering of these risk factors in what is termed the metabolic syndrome hence multiplying their overall risk. Obesity increases the risk of CAD in adults and has been strongly associated with insulin resistance in normoglycemic persons and in individuals with type 2 DM.