Blockade of the renin-angiotensin-aldosterone system: a key therapeutic strategy to reduce renal and cardiovascular events in patients with diabetes

Details

Serval ID
serval:BIB_D29795B7F19E
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Blockade of the renin-angiotensin-aldosterone system: a key therapeutic strategy to reduce renal and cardiovascular events in patients with diabetes
Journal
Journal of Hypertension
Author(s)
Burnier  M., Zanchi  A.
ISSN
0263-6352
Publication state
Published
Issued date
01/2006
Peer-reviewed
Oui
Volume
24
Number
1
Pages
11-25
Notes
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Review --- Old month value: Jan
Abstract
Diabetes (particularly type 2 diabetes) represents a global health problem of epidemic proportions. Individuals with diabetes are not only more likely to develop hypertension, dyslipidemia, and obesity, but are also at a significantly higher risk for coronary heart disease, peripheral vascular disease, and stroke. Angiotensin II plays a key pathophysiological role in the progression of diabetic renal disease, and blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II antagonists has therefore become an important therapeutic strategy to reduce renal and cardiovascular events in patients with diabetes. Several studies have demonstrated the effects of angiotensin II antagonists on the reduction of albuminuria and the progression of renal disease from microalbuminuria to macroalbuminuria. More importantly, several endpoint trials have shown that the antiproteinuric effects of losartan and irbesartan translate into cardiovascular and renoprotective benefits beyond blood pressure lowering, thereby delaying the need for dialysis or kidney transplantation by several years. These and other studies indicate that angiotensin II antagonists not only improve survival and quality of life of patients with diabetic nephropathy, but also have the potential to reduce the substantial healthcare burden associated with managing these patients. ACEi also appear to exert similar beneficial effects in diabetic patients, but whether clinically significant differences in renoprotection or mortality exist between angiotensin II antagonists and ACEi in patients with type 2 diabetes remains to be fully investigated in appropriate head-to-head studies.
Keywords
Angiotensin II Type 1 Receptor Blockers/economics/pharmacology/*therapeutic use Angiotensin-Converting Enzyme Inhibitors/economics/pharmacology/*therapeutic use Biphenyl Compounds/economics/pharmacology/therapeutic use Clinical Trials as Topic Cost-Benefit Analysis Diabetes Mellitus, Type 2/*complications/physiopathology/prevention & control Diabetic Angiopathies/mortality/physiopathology/*prevention & control Diabetic Nephropathies/mortality/physiopathology/*prevention & control Diabetic Neuropathies/mortality/physiopathology/*prevention & control Disease Progression Humans Hypertension/drug therapy/physiopathology Losartan/economics/pharmacology/therapeutic use Renin-Angiotensin System/*drug effects/physiology Tetrazoles/economics/pharmacology/therapeutic use
Pubmed
Web of science
Create date
11/02/2008 9:30
Last modification date
20/08/2019 15:52
Usage data