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Diabetes, the Renin-Angiotensin System and Heart Disease
Authors: Lim H.; Lip G.Y.H.
Source: Current Vascular Pharmacology, Volume 1, Number 2, June 2003 , pp. 225-238(14)
Publisher: Bentham Science Publishers
Abstract:
Despite recent advances, cardiovascular disease continues to be the leading cause of death among patients with diabetes. Diabetes-related heart disease makes up the majority of the cardiovascular morbidity and mortality and this clinical entity results from synergistic interaction amongst various overlapping mechanisms. Diabetes-related heart disease is characterised by a propensity to develop premature, diffuse atherosclerotic disease, structural and functional abnormalities of the microvasculature, autonomic dysfunction and intrinsic myocardial dysfunction (the so-called diabetic ‘cardiomyopathy’), all of which are exacerbated by hypertension and diabetic nephropathy. The renin-angiotensinaldosterone system possesses various autocrine and paracrine effects which drive most of the pathophysiological mechanisms in diabetes-related heart disease. This review aims to describe the expanding role of the renin-angiotensinaldosterone system, the complex entity of diabetes-related heart disease and the (emerging) evidence for specific inhibition of the renin-angiotensin-aldosterone system in diabetes.Keywords: renin-angiotensin system; diabetes; cardiovascular disease
Document Type: Review article
DOI: http://dx.doi.org/10.2174/1570161033476682
Publication date: 2003-06-01
- Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials.
Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units). Current Vascular Pharmacology will publish reviews to update all those concerned with the treatment of vascular disease. For example, reviews commenting on recently published trials or new drugs will be included. In addition to clinically relevant topics we will consider 'research-based' reviews dealing with future developments and potential drug targets. Therefore, another function of Current Vascular Pharmacology is to bridge the gap between clinical practice and ongoing research.
Debates will also be encouraged in the correspondence section of this journal.
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- In this Subject: Cardiovascular Medicine , Pharmacology
- By this author: Lim H. ; Lip G.Y.H.
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