Role of renin-angiotensin system blockade in patients with diabetes mellitus

Manoela F B Braga, Lawrence A Leiter
American Journal of Cardiology 2009 September 15, 104 (6): 835-9
The investigators review the evidence of the potential role of renin-angiotensin system (RAS) blockers in delaying or preventing the onset and progression of diabetes mellitus (DM) and cardiovascular disease and the suggested mechanisms by which these agents exert their favorable metabolic and cardiovascular effects. Data from clinical trials suggest that RAS blockade not only reduces cardiovascular risk in patients with DM but also may prevent or delay DM onset in at-risk subjects. These observations set the stage for further studies evaluating the risk for developing DM as a primary end point: the Diabetes Reduction Approaches With Ramipril And Rosiglitazone Medications (DREAM) trial, in which ramipril significantly increased regression to normoglycemia (although it did not reduce the primary end point of new-onset DM or death), and the ongoing Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial, the only DM prevention trial also powered to evaluate whether a reduced risk for DM is associated with a reduction in cardiovascular disease events. In conclusion, overwhelming evidence suggests that the RAS plays an important role in the pathogenesis of DM and its associated cardiovascular risks.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"