Abstract
Common occurrence of type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) is associated with very high risk of vascular complications. Recently, a big attention is paid to the link between macrovascular complicantions, i.e. atherosclerotic cardiovascular diseases, and microvascular complications, i.e. diabetic nephropathy and retinopathy.
Even though the structural and functional alterations are different between big arteries and small arterioles and capillaries, they has a common risk factors, which stimulate renin-angiotensin system and sympathetic nervous system. Nevertheless the implemented standard treatment in patients with T2DM and AH (RAS inhibitors and other antihypertensive drugs, statins, antidiabetic therapy), the high residual vascular risk persists in the whole arterial circulation system.
Atherogenic dyslipidemia, which is developping on the insulin resistance background, plays the main role in residual vascular risk. High atherogenity of this non-LDL dyslipidemia is explained and undervalued evidence of fenofibrate treatment is remained.
Fenofibrate therapy reduces residual vascular risk in patients with T2DM and AH significantly. Mechanisms of microvascular benefit of fenofibrate are mentioned.