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Cardiac, renal and vascular complications in the diabetic patient

Centre of Clinical Physiology and Hypertension, University of Milan, Ospedale Maggiore and Istituto Auxologico Italiano, Milan, Italy, Zanchett{at}mailserver.unimi.it

Type 2 diabetes has long been known to be associated with an increased risk of cardiovascular disease. Patients with type 2 diabetes have also been shown to benefit more from antihypertensive therapy than do non-diabetics with hypertension. The benefits of aggressive antihypertensive therapy are reflected in the recent reduction of blood pressure (BP) targets in international guidelines. Drugs acting on the reninangiotensin-aldosterone system (RAAS) have well-documented efficacy, and results from large-scale trials with highly selective angiotensin II (Ang II) receptor blockers (ARBs), such as valsartan, are awaited. The VALUE trial will provide the largest body of information yet on the comparative benefits of using an ARB or calcium channel blocker in hypertensive patients with diabetes.

Key Words: diabetes • HOT • SHEP • Syst-Eur • Ang II receptor blockade • VALUE • cardiovascular disease • renal insufficiency • ACE inhibitor • cardiovascular mortality

References

• Curb JD, Pressel SL, Cutler JA et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA 1996;276:1886-92.[Abstract/Free Full Text]
• Tuomilehto J., Rastenyte D., Birkenhäger WH et al. Effects of calcium-channel blockade in older patients with diabetes and systolic hypertension. Systolic Hypertension in Europe Trial Investigators.NEnglJMed 1999;340:677-84.[Abstract/Free Full Text]
• Hansson L., Zanchetti A., Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998;351:1755-62.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Ruilope L., Salvetti A., Jamerson K. et al. Renal function and intensive lowering of the blood pressure in the hypertensive subjects of the Hypertension Optimal Treatment (HOT) Study. J Am Soc Nephrol (in publication).
• UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. BMJ 1998;317:703-13.[Abstract/Free Full Text]
• Guidelines Subcommittee. 1999 World Health Organization-International Society of Hypertension guidelines for the Management of Hypertension. J Hypertens 1999;17: 151-83.[Web of Science][Medline] [Order article via Infotrieve]
• UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes. BMJ 1998;317:713-20.[Abstract/Free Full Text]
• Estacio RO, Jeffers BW, Hiatt WR, Biggerstaff SL, Gifford N., Schrier RW The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med 1998;338:645-52.[Abstract/Free Full Text]
• Lindholm LH, Hansson L., Ekbom T. et al. Comparison of antihypertensive therapies in preventing cardiovascular events in elderly diabetics: results from the Swedish trial in old patients with hypertension-2. J Hypertens 2000;18:1671-5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Tuomilehto J. Preventing cardiovascular disease in hypertensive patients with type 2 diabetes: is there a superior antihypertensive therapy? J Hypertens 2000;18:1553-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Muirhead N., Feagan BF, Mahon J. The effects of valsartan and captopril on reducing microalbuminuria in patients with type 2 diabetes mellitus: a placebo-controlled trial. Curr Ther Res 2000;60:650-60.[CrossRef]
• Thurmann PA, Kenedi P., Schmidt A. et al. Influence of the angiotensin II antagonist valsartan on left ventricular hypertrophy in patients with essential hypertension. Circulation 1998;98:2037-42.[Abstract/Free Full Text]
• Julius S. Long-term potential of angiotensin receptor blockade for cardiovascular protection in hypertension: the VALUE trial. Valsartan Antihypertensive Long-term Use Evaluation. Cardiology 1999;91(Suppl 1):8-13.[Web of Science][Medline] [Order article via Infotrieve]
• Kjeldsen SE, Julius S., Bach D. et al. Characteristics of 15,290 hypertensive patients with high coronary risk. The VALUE Trial. Blood Pressure (in publication).

Journal of Renin-Angiotensin-Aldosterone System, Vol. 1, No. 2 suppl, S21-S24 (2000)
DOI: 10.3317/jraas.2000.049


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Zanchetti, A. Search for Related Content PubMed PubMed Citation Articles by Zanchetti, A. Social Bookmarking                         What's this?