The increasingly large number of patients with diabetes in the UK are at greatly increased risk of cardiovascular disease, including coronary heart disease and stroke, compared to the general population. Many diabetes patients exhibit metabolic syndrome and these additional risk factors, such as raised hypertension and cholesterol, multiply the overall risk. Reducing these risk factors to target levels is essential and requires a multifactorial approach. Lifestyle changes, tight glycaemic control, antiplatelet drugs (aspirin) and control of lipid levels, e.g. using statins, can all have significant beneficial effects. Blood pressure control is another vital aspect in reducing risk and a number of recent studies have provided evidence supporting the use of angiotensin-converting enzyme inhibitors as first-line treatment in patients with diabetes.
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