Smoking microalbuminuria

In early studies on microalbuminuria smoking was identified as a powerful predictor of microalbuminuria [16,17]. This has recently been confirmed and extended in large population based studies. In the PREVEND study Pinto-Sietsma [18] found that current smokers had an adjusted relative risk of microalbuminuria of 1.65, former smokers a RR of 1.27, but heavy smokers > 20 cigarettes per day a RR of 1.96. This finding was confirmed in the ARIC study where the odds ratio for current smokers was 2.33 and in former smokers 1.58 [19]. 

Reduction in risk of Ml, stroke, and death from cardiovascular causes - In patients 55 years of age or older at high risk of developing a major cardiovascular event because of a history of coronary artery disease, stroke, peripheral vascular disease, or diabetes that is accompanied by at least 1 other cardiovascular risk factor (eg, hypertension, elevated total cholesterol levels, low FIDL levels, cigarette smoking, documented microalbuminuria). 

The CARDS randomized 2838 people with Type 2 diabetes plus retinopathy, microalbuminuria, hypertension, or smoking and no history of macrovascular disease to receive either ator-vastatin or placebo. Atorvastatin reduced the combined... 

No proteinuria Monitor blood pressure Monitor blood glucose Screen for microalbuminuria if type 1 diabetes for >5 years or type 2 diabetes Aim for <130/80 mmHg Aim for <120/70 mmHg if type 1 diabetes Aim for HbAlc <7% Dietary advice for sugar and fat STOP SMOKING... 

Scott LJ,Warram JH, Hanna LS, Laffel LM, Ryan L, Krolewski AS A nonlinear effect of hyperglycemia and current cigarette smoking are major determinants of the onset of microalbuminuria in type 1 diabetes. D/abefes 50 2842-2849, 2001. 

During recent years numerous prospective studies have identified several modifiable risk factors for CVD in patients with type 2 diabetes. On top of hyperglycaemia these factors include hypertension, dyslipidaemia, microalbuminuria, a pro-thrombotic state, visceral fat accumulation, and associated chronic low-grade inflammation, smoking, diets... 

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