The role of renin-angiotensin agents in altering the natural history of type 2 diabetes mellitus.
Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease (CVD) morbidity and mortality worldwide. Renin-angiotensin system (RAS) blockers have been indispensable in diminishing the macrovascular and microvascular complications of diabetes. In addition, cumulative evidence from retrospective studies pointed toward a beneficial effect of RAS agents in preventing the development and progression of T2DM. This disease-modifying potential of RAS blockers has been substantiated by recent prospective trials. Contemporary concepts regarding the natural history of T2DM and the pathophysiologic processes involved have increased our understanding of the mechanisms underlying the therapeutic potential of these agents in diabetes management. In addition to their established roles in the primary prevention of CVD in patients with diabetes, RAS blockers might be considered a suitable therapeutic choice for preventing the development of frank diabetes in high-risk patients.
Lardizabal
Joel A
JA
Department of Medicine, University of California in San Francisco (Fresno-MEP), 155 North Fresno Street, Fresno, CA 93701, USA. dr_jolar@yahoo.com
Deedwania
Prakash C
PC
D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D018450:Disease Progression; D006801:Humans; D007333:Insulin Resistance; D055806:Microvessels; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012307:Risk Factors; D015398:Signal Transduction
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001786:Blood Glucose
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