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Effects of Renin-Angiotensin-Aldosterone System Blockade on Diabetic Patients

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Diabetes mellitus rate is rising worldwide and is now recognized as the most common cause of endstage renal disease and blindness among adults, and a major risk factor for cardiovascular disease. Diabetics present more extensive atherosclerosis, and particularly, the type 2 diabetes mellitus patients are often obese, hypertensive, and dyslipidaemic subjects, sharing the criteria of the metabolic syndrome. Nowadays, the reninangiotensin system (RAS) can be considered a cascade of peptide hormones which play an important role in the development of several cellular and hemodynamic alterations among diabetics. Diabetes mellitus is now considered an inflammatory disease, since its origin in either type 1 or type 2, and there is growing evidence that insulin resistance, nephropathy, increased thrombotic risk, and endothelial dysfunction are all linked to RAS activation. In recent years, several studies showed the clear efficacy of angiotensin-converting enzyme inhibitors and angiotensin receptor blocking agents in reducing vascular complications and metabolic disorders. However, the precise role of the RAS blockade, including aldosterone inhibition, in modifying the morbidity and mortality associated with diabetes, is waiting for large, randomized and controlled clinical trials.
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Keywords: angiotensin-II receptor blockade; angiotensin-converting enzyme blockade; diabetes; endothelial function; inflammation; renal disease; renin-angiotensin system; thrombosis

Document Type: Review Article

Affiliations: Lipides, Aterosclerose e Biologia Vascular, Disciplina de Cardiologia - Universidade Federal de Sao Paulo, UNIFESP, Rua Pedro de Toledo 458, Sao Paulo, Brazil, 04039- 001.

Publication date: 2005-11-01

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  • Current Enzyme Inhibition aims to publish all the latest and outstanding developments in enzyme inhibition studies with regards to the mechanisms of inhibitory processes of enzymes, recognition of active sites, and the discovery of agonists and antagonists, leading to the design and development of new drugs of significant therapeutic value. Each issue contains a series of timely, in-depth reviews written by leaders in the field, covering a range of enzymes that can be exploited for drug development. Current Enzyme Inhibition is an essential journal for every pharmaceutical and medicinal chemist who wishes to have up-to-date knowledge about each and every development in the study of enzyme inhibition.
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