Feature Article

Pathophysiology of the effects of hypoglycemia on the cardiovascular system

Elaine Chow and Simon R Heller

Diabetic Hypoglycemia June 2012, Volume 5, Issue 1: page 3-8

Abstract

Cardiovascular disease (CVD) is the leading cause of death in people with diabetes. Hypoglycemia has been associated with increased cardiovascular mortality in recent studies of intensive glycemic therapy in people with type 2 diabetes. Experimental studies have shown that acute hypoglycemia has a number of adverse cardiovascular effects, which may promote atherothrombosis, cardiac ischemia and abnormal cardiac repolarization. Cardiac autonomic function is disrupted during acute hypoglycemia, which may extend beyond the acute episode. Many of these effects are mediated through sympathoadrenal activation. The clinical relevance of these mechanisms in precipitating cardiovascular events remains to be established. However, aggressive glycemic targets that increase the risk of hypoglycemia should likely be avoided in subgroups with advanced CVD.

Keywords: diabetes, hypoglycemia, cardiovascular disease, intensive glycemic control