Mechanism of Hypoglycemia-Associated Cardiovascular Diseases.

Kang,  Yu Mi; Lee,  Woo Je

doi:2016.17.1.24

J Korean Diabetes > Volume 17(1); 2016 > Article

Focused Issue

The Journal of Korean Diabetes 2016;17(1):24-29.
DOI: https://doi.org/10.4093/jkd.2016.17.1.24 Published online April 12, 2016.

저혈당에 의한 심혈관질환 발생 기전

강유미, 이우제

Mechanism of Hypoglycemia-Associated Cardiovascular Diseases.

Yu Mi Kang, Woo Je Lee

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. lwjatlas@amc.seoul.kr

Abstract

Cardiovascular disease (CVD) is the leading cause of death in patients with diabetes mellitus. However, the benefit of intensive glycemic control in reducing CVD is unclear. In large clinical trials, intensive glycemic control was associated with increased incidence of hypoglycemia and all-cause mortality. Although it is uncertain whether hypoglycemia is a direct cause of CVD, a marker of vulnerability, or both, numerous studies have reported that hypoglycemia is associated with increased cardiovascular events such as cardiac arrhythmia and ischemia. The potential mechanisms of hypoglycemia-associated CVD include sympathoadrenal activation, repolarization abnormality, cardiac autonomic neuropathy, increased thrombogenesis, inflammatory reaction, and endothelial dysfunction. In this article, we review the evidence of an association of hypoglycemia with CVD in patients with diabetes and discuss the possible mechanisms through which hypoglycemia might result in adverse cardiovascular outcomes.

Key Words: Cardiovascular diseases, Diabetes mellitus, Hypoglycemia, Mechanism