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The cause of diabetes mellitus is metabolic in origin. However, its major clinical manifestations, which result in most of the morbidity and mortality, are a result of its vascular pathology. In fact, the American Heart Association has recently stated that, "from the point of view of cardiovascular medicine, it may be appropriate to say, diabetes is a cardiovascular disease" (1). But diabetic vascular disease is not limited to just the macrovasculature. Diabetes mellitus also affects the microcirculation with devastating results, including nephropathy, neuropathy, and retinopathy. Diabetic nephropathy is the leading cause of end-stage renal disease in the United States, while diabetic retinopathy is the leading cause of new-onset blindness in working-age Americans. The importance of this text on Diabetes and Cardiovascular Disease is evident by the magnitude of the population affected by diabetes mellitus. Over 10 million Americans have been diagnosed with diabetes mellitus, while another 5 million remain undiagnosed. The impact from a public health perspective is huge and increasing. As the population of the United States grows older, more sedentary, and obese, the risk of developing diabetes and its complications will increase. Epidemiological studies have identified diabetes mellitus as a major independent risk factor for cardiovascular disease. Over 65% of patients with diabetes mellitus die from a cardiovascular cause. The prognosis of patients with diabetes mellitus who develop overt clinical cardiovascular disease is much worse than those cardiovascular patients free of diabetes mellitus.

In this second edition of Diabetes and Cardiovascular Disease, Michael T. Johnstone, MD, and Aristidis Veves, MD, have updated and expanded their very successful classic text to reflect new research, advances in clinical care, and the growing recognition that diabetes mellitus is a risk factor for cardiovascular disease. Written for the practicing clinician as a comprehensive review of diabetic vascular disease, the book both explains the basic pathophysiology of the disease and details the latest diagnostic and therapeutic approaches. On the science side, the authors have added new chapters on the role of estrogens in diabetic vascular disease, PARP activation and nitrosative stress in the development of the cardiovascular system, adiponectin and the cardiovascular system, and PPARs and their emerging role in vascular biology, inflammation, and atherosclerosis. On the clinical side, readers will find new chapters on percutaneous interventional therapy in cardiac and peripheral vascular disease, cardiovascular surgery in diabetic patients, and therapeutic interventions to improve endothelial function in diabetes. The chapters on diabetes and hypertension, heart failure, and coronary artery disease have been extensively revised, offering a cutting-edge discussion of retinopathy, nephropathy, neuropathy, and microcirculation of the diabetic foot. Authoritative and comprehensive, Diabetes and Cardiovascular Disease, Second Edition offers practicing physicians a cutting-edge scientific and clinical review of diabetic cardiovascular disease, providing both a deeper understanding of its pathology and all the day-to-day practical knowledge needed to treat patients effectively.