An update of irbesartan and renin-angiotensin system blockade in diabetic nephropathy.
Type 2 diabetes is a chief cause of pathologies such as cardiovascular disease, nephropathy and retinopathy, and its prevalence is increasing worldwide. Development of renal disease can be slowed by tight glycaemic control and treatment of associated hypertension with angiotensin-converting enzyme inhibition, as The Diabetes Control and Complications Trial and the UK Prospective Diabetes Study have demonstrated. Recent clinical trials have supported the use of angiotensin II receptor antagonists in the treatment of diabetic nephropathy, resulting in the approval of new therapeutic indications in the US and Europe. The main goal of this review is to demonstrate how results from the Programme for Irbesartan Mortality and Morbidity Evaluation and other recent studies, based on the effects of renin-angiotensin system blockade, can be appropriate in clinical practice, thus displaying benefits of irbesartan therapy at any stage of renal disease in diabetics.
García-Donaire
Jose Antonio
JA
Hypertension Unit, Hospital 12 de Octubre, Av. Córdoba s/n28041 Madrid, Spain.
Segura
Julian
J
Ruilope
Luis Miguel
LM
D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000191:economics / Q000401:mortality / Q000517:prevention & control; D018753:Diet, Protein-Restricted; D005060:Europe / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D000077405:Irbesartan; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000191:economics / Q000401:mortality / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D017257:Ramipril / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects*; D013777:Tetrazoles / Q000494:pharmacology / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D001713:Biphenyl Compounds; D013777:Tetrazoles; D000077405:Irbesartan; D017257:Ramipril