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 HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Deedwania, P. C
Right arrow Articles by Schmieder, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Deedwania, P. C
Right arrow Articles by Schmieder, R.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Metabolic Syndrome
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?

Angiotensin Receptor Blockers: Cardiovascular Protection in the Metabolic Syndrome

Prakash C Deedwania

University of California at San Francisco, San Francisco, CA, USA, deed{at}fresno.ucsf.edu

Roland Schmieder

University of Erlangen-Nuremberg, Germany

It is well recognised that the metabolic syndrome, a constellation of risk factors including obesity, hypertension, insulin resistance and dyslipidaemia, is associated with an increased risk of cardiovascular complications and the development of Type 2 diabetes. Consequently, timely identification and management of all components of the metabolic syndrome is warranted. In particular, guidelines have emphasised the importance of targeting elevated blood pressure (BP) and dyslipidaemia as a method of reducing global cardiovascular risk.

Findings from the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial show that the angiotensin receptor blocker, valsartan, reduces cardiovascular events and the development of Type 2 diabetes in high-risk individuals. This profile is being further explored in the ongoing Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial.

Given the potential advantages to patients and physicians of tackling more than one of the components of the metabolic syndrome, antihypertensive agents such as valsartan would appear to be an important addition to the management of vulnerable patients at high risk of cardiovascular events.

Key Words: Valsartan • Angiotensin receptor blockers • Hypertension • Metabolic syndrome

References

  • Deedwania PC Metabolic syndrome and vascular disease. Is nature or nurture leading the new epidemic of cardiovascular disease? Circulation 2004;109:2-4.[Free Full Text]
  • Hall JE, Crook ED, Jones DW, Wofford MR, Dubbert PM Mechanisms of obesity-associated cardiovascular and renal disease. Am J Med Sci 2002;324:127-37.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Deedwania PC, Volkova N. Current treatment options for the metabolic syndrome. Curr Treat Options Cardiovasc Med 2005;7:61-74.[Medline] [Order article via Infotrieve]
  • Landsberg L. Insulin and hypertension: lessons from obesity. N Engl J Med 1987;317:378-95.[Web of Science][Medline] [Order article via Infotrieve]
  • Reaven GM Role of insulin resistance in human disease (syndrome X): an expanded definition. Annu Rev Med 1993;44:121-31.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Grundy SM, Brewer HB, Cleeman JI et al. Definition of metabolic syndrome: report of the National Heart, Lung and Blood Institute/American Heart Conference on scientific issues related to definition. Arterioscler Thromb Vasc Biol 2004;24:e13-18.[Free Full Text]
  • Alberti KG, Zimmet PZ Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med 1998;15:539-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.[Free Full Text]
  • Lakka HM, Laaksonen DE, Lakka TA et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002;288:2709-16.[Abstract/Free Full Text]
  • Ninomiya JK, L'Italien G., Criqui MH et al. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation 2004;109(1):42-6.[Abstract/Free Full Text]
  • Laaksonen DE, Lakka HM, Niskanen LK et al. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 2002;156:1070-7.[Abstract/Free Full Text]
  • Hanson RL, Imperatore G., Bennett PH, Knowler WC Components of the "metabolic syndrome" and incidence of Type 2 diabetes. Diabetes 2002;5:3120-7.
  • Grundy SM, Hansen B., Smith SC Jr et al. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/ American Diabetes Association conference on scientific issues related to management. Circulation 2004;109:551-6.[Free Full Text]
  • Després JP Health consequences of visceral obesity. Ann Med 2001;33:534-41.[Web of Science][Medline] [Order article via Infotrieve]
  • Montalescot G., Collet JP Preserving cardiac function in the hypertensive patient: why renal parameters hold the key. Eur Heart J 2005;8:[ePub ahead of print]
  • Hanley AJ, Williams K., Stern MP, Haffner SM Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the San Antonio Heart Study. Diabet Care 2002;25:1177-84.[Abstract/Free Full Text]
  • Sattar N., Gaw A., Scherbakova O. et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003;108:414-19.[Abstract/Free Full Text]
  • Creager MA, Luscher TF, Cosentino F., Beckman JA Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I. Circulation 2003; 108:1527-32.[Free Full Text]
  • McNeill AM, Rosomond WD, Girman CJ et al. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the Atherosclerosis Risk In Communities study. Diabet Care 2005;28:385-90.[Abstract/Free Full Text]
  • Lakka H., Laaksonen D., Lakka T. et al. The metabolic syndrome and total and cardiovascular disease mortality in middle aged men. JAMA 2002;288:2709-16.[Abstract/Free Full Text]
  • Zeller M., Steg PG, Ravisy J. et al. Prevalence and impact of metabolic syndrome on hospital outcomes in acute myocardial infarction. Arch Intern Med 2005;165:1192-8.[Abstract/Free Full Text]
  • Wilson PW, D'Agostino RB, Parise H., Sullivan L., Meigs JB Metabolic syndrome as a precursor of cardiovascular disease and Type 2 diabetes mellitus. Circulation 2005;112:3066-72.[Abstract/Free Full Text]
  • Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabet Care 1999;22:141-6.[Abstract/Free Full Text]
  • Solomon CG, Hu FB, Dunaif A. et al. Long or highly irregular menstrual cycles as a marker for risk of Type 2 diabetes mellitus. JAMA 2001;286:2421-6.[Abstract/Free Full Text]
  • Hanley A., Wagenknecht L., Festa A. et al. Liver markers and risk of incident metabolic syndrome (MetS) [abstract]. Program and abstracts of the 65th Scientific Sessions of the American Diabetes Association; June 10-14, 2005; San Diego, California.
  • Eckel RH, Krauss RM American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998;97:2099-100.[Free Full Text]
  • Chobanian AV, Bakris GL, Black HR et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206-52.[Abstract/Free Full Text]
  • Dzau V., Braunwald E. Resolved and unresolved issues in the prevention and treatment of coronary artery disease: a workshop consensus statement. Am Heart J 1991;121:1244-63.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Burnier M., Brunner HR Angiotensin II receptor antagonists. Lancet 2000;355:637-45.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Weir MR, Dzau VJ The renin-angiotensin-aldosterone system: a specific target for hypertension management. Am J Hypertens 1999;12:205S-213S.[Web of Science][Medline] [Order article via Infotrieve]
  • Cohn JN, Tognoni G. for the Valsartan Heart Failure Trial Investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001;345:1667-75.[Abstract/Free Full Text]
  • Pfeffer MA, McMurray JJ, Velazquez EJ et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. N Engl J Med 2003;349:1893-906.[Abstract/Free Full Text]
  • Julius S., Kjeldsen SE, Weber M. et al. for the VALUE trial group. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004;363:2022-31.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Corea L., Cardoni O., Fogari R. et al. Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: a comparative study of the efficacy and safety against amlodipine. Clin Pharmacol Ther 1996;60:341-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Hegner G., Faust G., Freytag F., Meilenbrock S., Sullivan J., Bodin F. Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: efficacy and safety compared to hydrochlorothiazide. Eur J Clin Pharmacol 1997;52:173-7.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Mallion J-M., Boutelant S., Chabaux P. et al. Valsartan, a new angiotensin II antagonist: blood pressure reduction in essential hypertension compared with an angiotensin converting enzyme inhibitor, enalapril. Blood Press Monit 1997;2:179-84.[Medline] [Order article via Infotrieve]
  • Mahmud A., Feely J. Favourable effects on arterial wave reflection and pulse pressure amplification of adding angiotensin II receptor blockade in resistant hypertension. J Hum Hypertens 2000;14:541-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Fogari R., Zoppi A., Carretta R., Veglio F., Salvetti A. for the Italian Collaborative Study Group. Effect of indomethacin on the antihypertensive efficacy of valsartan and lisinopril: a multicentre study. J Hypertens 2002;20:1007-14.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Campbell R., Sangalli F., Perticucci E. et al. Effects of combined ACE inhibitor and angiotensin II antagonist treatment in human chronic nephropathies. Kidney Int 2003; 63:1094-103.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Klingbeil AU, John S., Schneider MP, J. Jacobi, Handrock R., Schmieder RE Effect of AT1 receptor blockade on endothelial function in essential hypertension. Am J Hypertens 2003; 16:123-8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Mallion J-M., Carretta R., Trenkwalder P. et al. Valsartan/ hydrochlorothiazide is effective in hypertensive patients
  • Calvo C., Hermida RC, Ayala DE, Ruilope LM Effects of telmisartan 80 mg and valsartan 160 mg on ambulatory blood pressure in patients with essential hypertension. J Hypertens 2004;22:837-46.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Waeber B., Aschwanden R., Sadecky L., Ferber P. Combination of hydrochlorothia zide or benazepril with valsartan in hypertensive patients unresponsive to valsartan alone. J Hypertens 2001;19:2097-104.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Fogari R., Mugellini A., Zoppi A. et al. Effects of valsartan compared with enalapril on blood pressure and cognitive function in elderly patients with essential hypertension. Eur J Clin Pharmacol 2004a;59:863-8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Malacco E., Piazza S., Scandiani L., Zoppi A. Valsartan/ hydrochlorothiazide versus amlodipine on ambulatory blood pressure and plasma norepinephrine levels in high-risk hypertensive patients. Adv Ther 2004;21:149-61.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Malacco E., Vari N., Capuano V. et al. for the Val-Syst Investigators. A randomized, double-blind, active-controlled, parallel-group comparison of valsartan and amlodipine in the treatment of isolated systolic hypertension in elderly patients: the Val-Syst Study. Clin Ther 2003;25:2765-80.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Ruilope LM, Malacco E., Khder Y., Kandra A., Bonner G., Heintz D. Efficacy and tolerability of combination therapy with valsartan plus hydrochlorothiazide compared with amlodipine monotherapy in hypertensive patients with other cardiovascular risk factors: the VAST study. Clin Ther 2005;27:578-87.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Cifkova R., Peleska J., Hradec J. et al. Valsartan and atenolol in patients with severe essential hypertension. J Hum Hypertens 1998;12:563-7.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Fogari R., Preti P., Zoppi A. et al. Effect of valsartan and atenolol on sexual behavior in hypertensive postmenopausal women. Am J Hypertens 200;17:77-81.
  • European Society of Hypertension-European Society of Cardiology Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003;21:1011[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Whitworth JA World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 2003;21:1983-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kjeldsen SE, Julius S., Weber MA, Stolt P. Main results from VALUE. In: Oparil S, Weber MA, eds. Hypertension: A companion to Brenner and Rector's The Hypertension: A Companion to Brenner and Rector's The Kidney. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2005:376-80.
  • Fogari R., Derosa G., Zoppi A. et al. Comparison of the effects of valsartan and felodipine on plasma leptin and insulin sensitivity in hypertensive obese patients. Hypertens Res 2005;28:209-14.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Nomura S., Shouzu A., Omoto S. et al. Effect of valsartan on monocyte/endothelial cell activation markers and adiponectin in hypertensive patients with Type 2 diabetes mellitus. Thromb Res 2006;117:385-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • McMurray JJ, Califf R., Holman R. et al. Cardiologists should care about glucose: most people with cardiovascular disease or risk factors have diabetes or significant glycaemic abnormalities. Results of screening over 39,000 subjects for NAVIGATOR [abstract]. Eur Heart J 2004;25(Suppl):239.
  • Sharma AM, Janke J., Gorzelniak K., Engeli S., Luft FC Angiotensin blockade prevents Type 2 diabetes formation by fat cells. Hypertension 2002;40:609-11.[Abstract/Free Full Text]
  • Cooper ME The role of the renin-angiotensin aldosterone system in diabetes and its vascular complications. Am J Hypertens 2004;17:16S-20S.[Web of Science][Medline] [Order article via Infotrieve]

Journal of Renin-Angiotensin-Aldosterone System, Vol. 7, No. 1 suppl, S12-S18 (2006)
DOI: 10.3317/jraas.2006.018
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 has been cited by other articles:


Home page
 HypertensionHome page
M. W. Brands and H. Labazi
Role of Glomerular Filtration Rate in Controlling Blood Pressure Early in Diabetes
Hypertension, August 1, 2008; 52(2): 188 - 194.
[Full Text] [PDF]

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 HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Deedwania, P. C
Right arrow Articles by Schmieder, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Deedwania, P. C
Right arrow Articles by Schmieder, R.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Metabolic Syndrome
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