Diabetes, hypertension, and renal insufficiency in post-myocardial infarction cardiovascular risk.
The prognosis for patients who suffer myocardial infarctions (MIs) is poor, with 22% of male and 46% of female survivors being disabled by heart failure within 6 years. Many well-established risk factors for increased morbidity and mortality post-MI are closely linked to the metabolic syndrome and associated with over-activation of the renin-angiotensin-aldosterone and sympathetic nervous systems. Results from numerous large-scale clinical endpoint trials have shown that blocking the deleterious effects of these systems with either an angiotensin-converting enzyme inhibitor or a beta-adrenoceptor antagonist significantly reduces the risk of mortality and cardiovascular events in post-MI patients. Results from 1 recent study of the beta-blocker, carvedilol, have shown further that these benefits extend to high-risk patients with either diabetes or hypertension.
Abraham
William T
WT
Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, Ohio State University, Columbus, Ohio, USA.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000209:etiology; D051437:Renal Insufficiency / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors