Lessons learned from recent clinical trials in hypertensive diabetics: what's good for the kidney is good for the heart and brain.

Hypertension and interactions of the activated renin-angiotensin-aldosterone system (RAAS) are major risk factors for both cardiovascular disease and renal disease in patients with diabetes. Recent clinical trials show that specific inhibition of the RAAS may significantly decrease morbidity and mortality from cardiovascular and renal causes in this high-risk population and reduce risk for new-onset diabetes in patients with hypertension. In addition, these trials demonstrated that benefits of RAAS blockade are mediated by both BP-dependent and -independent effects, and they suggest that the cardiovascular benefits of RAAS blockade may result from its favorable effects on both cardiac and renal function.