SAGE Journals Online
Advertisement
Sign In to gain access to subscriptions and/or personal tools.

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Advertisement

Sign In to gain access to subscriptions and/or personal tools.
Journal of Renin-Angiotensin-Aldosterone System
This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Davies, J.
Right arrow Articles by Struthers, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Davies, J.
Right arrow Articles by Struthers, A.
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Reviews

Review: The potential benefits of aldosterone antagonism in Type 2 diabetes mellitus

Justine Davies

Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, Scotland, j.i.davies@ dundee.ac.uk

Allan Struthers

Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, Scotland

Interest in the renin-angiotensin-aldosterone system (RAAS) has increased since the development of angiotensin-converting enzyme (ACE) inhibitors. It has been discovered that the potential uses of this class of treatment extend far beyond their initial developmental role as antihypertensives, and they are now used routinely in the treatment of heart failure, nephropathy, myocardial infarction and diabetes. However, there is more to RAAS blockade than just inhibition of angiotensin II, and inhibition of aldosterone is becoming recognised as an additional therapeutic manoeuvre in chronic heart failure.1

Since inhibition of the RAAS at the level of ACE is now seen to be an important therapy in diabetes; 2 the purpose of this article is to explore the potential benefits of additional aldosterone inhibition in Type 2 diabetes mellitus.

Key Words: diabetes • aldosterone • spironolactone

References

  • Pitt B., Zannad F., Remme WJ et al.The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999;341:709-17.[Abstract/Free Full Text]
  • Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000;355:253-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Fontbonne A., Charles MA, Thibult N. et al. Hyperinsulinaemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study, 15-year follow-up. Diabetologia 1991;34:356-61.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • MacFadyen RJ, Lee AF, Morton JJ, Pringle SD, Struthers AD How often are angiotensin II and aldosterone concentrations raised during chronic ACE inhibitor treatment in cardiac failure? Heart 1999;82:57-61.[Abstract/Free Full Text]
  • Farquharson CA, Struthers AD Gradual reactivation over time of vascular tissue angiotensin I to angiotensin II conversion during chronic lisinopril therapy in chronic heart failure. J Am Coll Cardiol 2002;39:767-75.[Abstract/Free Full Text]
  • Cohn JN,Tognoni G. A randomised trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001;345:1667-75.[Abstract/Free Full Text]
  • Struthers AD Why does spironolactone improve mortality over and above an ACE inhibitor in chronic heart failure? Br J Clin Pharmacol 1999;47:479-82.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Golestaneh N., Klein C., Valamanesh F., Suarez G., Agarwal MK, Mirshahi M. Mineralocorticoid receptor-mediated signaling regulates the ion gated sodium channel in vascular endothelial cells and requires an intact cytoskeleton. Biochem Biophys Res Commun 2001;280:1300-06.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Watzka M., Beyenburg S., Blumcke I., Elger CE, Bidlingmaier F., Stoffel-Wagner B. Expression of mineralocorticoid and glucocorticoid receptor mRNA in the human hippocampus. Neurosci Lett 2000;290:121-4.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Wickert L., Selbig J., Watzka M. et al. Differential mRNA expression of the two mineralocorticoid receptor splice variants within the human brain: structure analysis of their different DNA binding domains.JNeuroendocrinol 2000;12:867-73.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Dzau VJ Local expression and pathophysiological role of renin-angiotensin in the blood vessels and heart. Basic Res Cardiol 1993;88(suppl 1):1-14.
  • Mizuno Y., Yoshimura M., Yasue H. et al. Aldosterone production is activated in failing ventricle in humans. Circulation 2001;103:72-7.[Abstract/Free Full Text]
  • Okamura T., Aimi Y., Kimura H., Murakami K., Toda N. Existence of renin in the endothelium of human artery. J Hypertens 1992;10:49-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Engeli S., Gorzelniak K., Kreutz R., Runkel N., Distler A., SharmaAM Co-expression of renin-angiotensin system genes in human adipose tissue. J Hypertens 1999;17:555-60.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Price DA, De'Oliveira JM, Fisher ND, Williams GH, Hollenberg NK The state and responsiveness of the renin-angiotensin-aldosterone system in patients with type II diabetes mellitus. Am J Hypertens 1999;12:348-55.[Web of Science][Medline] [Order article via Infotrieve]
  • Chan JC, Cheung CK, Cockram CS et al. Atrial natriuretic peptide and renin-angiotensin-aldosterone system in non-insulin-dependent diabetes mellitus. J Hum Hypertens 1994; 8:451-6.[Web of Science][Medline] [Order article via Infotrieve]
  • Ferriss JB,Sullivan PA, Gonggrijp H., Cole M., O'Sullivan DJ Plasma angiotensin II and aldosterone in unselected diabetic patients. Clin Endocrinol 1982;17:261-9.[CrossRef][Medline] [Order article via Infotrieve]
  • de Chatel R., Weidmann P., Flammer J. et al. Sodium, renin, aldosterone, catecholamines and blood pressure in diabetes. Kidney Int 1977;12:412-21.[Web of Science][Medline] [Order article via Infotrieve]
  • McKnight JA, Sheridan B., Roberts G., Atkinson AB Basal and stimulated plasma atrial natriuretic factor in type 2 diabetes. Diabetes Res 1991;18:143-8.[Web of Science][Medline] [Order article via Infotrieve]
  • Epstein M., Sowers JR Diabetes mellitus and hypertension. Hypertension 1992;19:403-18.[Abstract/Free Full Text]
  • Swislocki AL, Siegel D. Renal effects of angiotensin-converting enzyme inhibitors that result in cost savings and improved patient outcomes. Am J Manag Care 2001;7:283-95.[Web of Science][Medline] [Order article via Infotrieve]
  • Mogensen CE, Neldam S., Tikkanen I. et al. Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study. BMJ 2000;321:1440-4.[Abstract/Free Full Text]
  • Lewis EJ, Hunsicker LG, Clarke WR et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001;345:851-60.[Abstract/Free Full Text]
  • Lindholm LH, Ibsen H., Dahlof B. et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002;359:1004-10.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Petrie JR, Morris AD, Ueda S. et al. Trandolapril does not improve insulin sensitivity in patients with hypertension and type 2 diabetes: a double-blind, placebo-controlled crossover trial. J Clin Endocrinol Metab 2000;85:1882-9.[Abstract/Free Full Text]
  • Seghieri G.,Yin W., Boni C. et al. Effect of chronic ACE inhibition on glucose tolerance and insulin sensitivity in hypertensive type 2 diabetic patients. Diabet Med 1992;9:732-8.[Web of Science][Medline] [Order article via Infotrieve]
  • Vuorinen-Markkola H., Yki-Jarvinen H. Antihypertensive therapy with enalapril improves glucose storage and insulin sensitivity in hypertensive patients with non-insulin-dependent diabetes mellitus.Metabolism 1995;44:85-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Yin W., Seghieri G., Boni C. et al. Effect of chronic ACE inhibition on glucose tolerance and insulin sensitivity in hypertensive type 2 diabetic patients. Chin Med Sci J 1994;9:29-33. 30. Estacio RO, Jeffers BW, Gifford N., Schrier RW Effect of blood pressure control on diabetic microvascular complications in patients with hypertension and type 2 diabetes. Diabetes Care 2000;23(suppl 2):B54-B64.[Web of Science][Medline] [Order article via Infotrieve]
  • Tatti P., Pahor M., Byington RP et al. Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998;21:597-603.[Abstract]
  • Fontbonne A., Charles MA, Thibult N. et al. Hyperinsulinaemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study, 15-year follow-up. Diabetologia 1991;34:356-61.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Cheetham C., O'Driscoll G., Stanton K., Taylor R., Green D. Losartan, an angiotensin type I receptor antagonist, improves conduit vessel endothelial function in Type II diabetes. Clin Sci 2001;100:13-17.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • O'Driscoll G., Green D., Maiorana A., Stanton K., Colreavy F., Taylor R. Improvement in endothelial function by angiotensin-converting enzyme inhibition in non-insulin-dependent diabetes mellitus. JAm Coll Cardiol 1999;33:1506-11.[Abstract/Free Full Text]
  • Taddei S., Virdis A., Mattei P., Salvetti A. Vasodilation to acetylcholine in primary and secondary forms of human hypertension.Hypertension 1993;21:929-33.[Abstract/Free Full Text]
  • Farquharson CA, Struthers AD Aldosterone induces acute endothelial dysfunction in vivo in man - evidence for an aldosterone-induced vasculopathy. Clin Sci 2002;103:425-31.[Web of Science][Medline] [Order article via Infotrieve]
  • Farquharson CA, Struthers AD Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure. Circulation 2000;101:594-7.[Abstract/Free Full Text]
  • Ascherio A., Rimm EB, Hernan MA et al. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation 1998;98:1198-204.[Abstract/Free Full Text]
  • Feng J He, Graham A MacGregor. Fortnightly review: Beneficial effects of potassium. BMJ 2001;323:497-501.[Free Full Text]
  • Landin K., Lindgarde F., Saltin B., Wilhelmsen L. Increased skeletal muscle Na/K-ratio in obese men, but not in women, with glucose intolerance. J Intern Med 1989;225:89-94.[Web of Science][Medline] [Order article via Infotrieve]
  • Guerrero-Romero F., Rodriguez-Moran M. Hypomagnesemia is linked to low serum HDL-cholesterol irrespective of serum glucose values. J Diabetes Complications 2000;14:272-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Lima M., Cruz T., Pousada JC, Rodrigues LE, Barbosa K., Cangucu V. The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care 1998;21:682-6.[Abstract]
  • Bashir Y., Sneddon JF, Staunton HA et al. Effects of long-term oral magnesium chloride replacement in congestive heart failure secondary to coronary artery disease. Am J Cardiol 1993;72:1156-62.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Zehender M., Meinertz T., Faber T. et al. Antiarrhythmic effects of increasing the daily intake of magnesium and potassium in patients with frequent ventricular arrhythmias. Magnesium in Cardiac Arrhythmias (MAGICA) Investigators. J Am Coll Cardiol 1997;29:1028-34.[Abstract]
  • Schmidt BM, Montealegre A., Janson CP et al. Short term cardiovascular effects of aldosterone in healthy male volunteers. J Clin Endocrinol Metab 1999;84:3528-33.[Abstract/Free Full Text]
  • Shechter M., Sharir M., Labrador MJ, Forrester J., Silver B., Bairey Merz CN Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Circulation 2000;102:2353-8.[Abstract/Free Full Text]
  • Taddei S., Mattei P., Virdis A.,Sudano I., Ghiadoni L., Salvetti A. Effect of potassium on vasodilation to acetylcholine in essential hypertension.Hypertension 1994;23:485-90.[Abstract/Free Full Text]
  • Rossing K., Christensen PK, Jensen BR, Parving HH Dual blockade of the renin-angiotensin system in diabetic nephropathy: a randomized double-blind crossover study. Diabetes Care 2002;25:95-100.[Abstract/Free Full Text]
  • Takahashi N., Nakagawa M., Saikawa T. et al. Effect of essential hypertension on cardiac autonomic function in type 2 diabetic patients. J Am Coll Cardiol 2001;38:232-7.[Abstract/Free Full Text]
  • Liao D., Sloan RP, Cascio WE et al. Multiple metabolic syndrome is associated with lower heart rate variability. The Atherosclerosis Risk in Communities Study. Diabetes Care 1998;21:2116-22.[Abstract]
  • Tsuji H., Larson MG, Venditti FJ Jr et al. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 1996;94:2850-5.[Abstract/Free Full Text]
  • Reaven GM, Lithell H., Landsberg L. Hypertension and associated metabolic abnormalities--the role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996;334:374-81.[Free Full Text]
  • Yee KM, Struthers AD Aldosterone blunts the baroreflex response in man. Clin Sci 1998;95:687-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Barr CS, Naas A., Freeman M., Lang CC, Struthers AD QT dispersion and sudden unexpected death in chronic heart failure. Lancet 1994;343:327-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • MacFadyen RJ, Barr CS, StruthersAD.Aldosterone blockade reduces vascular collagen turnover, improves heart rate variability and reduces early morning rise in heart rate in heart failure patients. Cardiovasc Res 1997;35:30-4.[Abstract/Free Full Text]
  • Malik RA Can diabetic neuropathy be prevented by angiotensin-converting enzyme inhibitors? Ann Med 2000; 32:1-5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kontopoulos AG,Athyros VG, Didangelos TP et al. Effect of chronic quinapril administration on heart rate variability in patients with diabetic autonomic neuropathy. Diabetes Care 1997;20:355-61.[Abstract]
  • Nielsen FS,Ali S., Rossing P. et al. Left ventricular hypertrophy in non-insulin-dependent diabetic patients with and without diabetic nephropathy. Diabet Med 1997;14:538-46. 59. van Hoeven KH, Factor SM A comparison of the pathological spectrum of hypertensive, diabetic, and hypertensive-diabetic heart disease. Circulation 1990;82:848-55.[Abstract/Free Full Text]
  • Levy D., Garrison RJ, Savage DD, Kannel WB, Castelli WP Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990;322:1561-6.[Abstract]
  • Fujimoto WY, Williams RH Insulin action on the cultured human fibroblast. Glucose uptake, protein synthesis, RNA synthesis. Diabetes 1974;23:443-8.[Medline] [Order article via Infotrieve]
  • Rabkin SW, Dawson KG, Bhaumick B., O'Brein E., Kendler DL Serum insulin, IGF-I,IGF-II and growth hormone, and left ventricular mass in non-insulin-dependent mellitus. Can J Cardiol 1996;12:264-70.[Web of Science][Medline] [Order article via Infotrieve]
  • Brilla CG, Rupp H., Funck R., Maisch B. The renin-angiotensin-aldosterone system and myocardial collagen matrix remodelling in congestive heart failure. Eur Heart J 1995;16(suppl O):107-09.[Abstract]
  • Schlaich MP, Schobel HP, Hilgers K., Schmieder RE Impact of aldosterone on left ventricular structure and function in young normotensive and mildly hypertensive subjects. Am J Cardiol 2000;85:1199-206.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Tsutamoto T., Wada A., Maeda K. et al. Effect of spironolactone on plasma brain natriuretic peptide and left ventricular remodeling in patients with congestive heart failure. J Am Coll Cardiol 2001;37:1228-33.[Abstract/Free Full Text]
  • Ewing DJ, Boland O., Neilson JM, Cho CG, Clarke BF Autonomic neuropathy, QT interval lengthening, and unexpected deaths in male diabetic patients. Diabetologia 1991;34:182-5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Veglio M., ChinagliaA, Cavallo PP The clinical utility of QT interval assessment in diabetes. Diabetes Nutr Metab 2000;13:356-65.[Web of Science][Medline] [Order article via Infotrieve]

Journal of Renin-Angiotensin-Aldosterone System, Vol. 3, No. 3, 150-155 (2002)
DOI: 10.1177/14703203020030030301


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?



This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Davies, J.
Right arrow Articles by Struthers, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Davies, J.
Right arrow Articles by Struthers, A.
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Advertisement