Open AccessValue of Angiotensin Receptor Blocker Therapy in Diabetes
Author(s) -
Izzo Jr Joseph L.,
Zion Adrienne S.
Publication year - 2011
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2011.00447.x
Subject(s) - medicine , microalbuminuria , diabetes mellitus , nephropathy , placebo , antihypertensive drug , diabetic nephropathy , disease , combination therapy , clinical trial , stroke (engine) , cardiology , blood pressure , endocrinology , pathology , alternative medicine , mechanical engineering , engineering
There are more clinical trials investigating angiotensin receptor blockers (ARBs) in diabetes than any other drug class, ranging from early “prevention” trials to the treatment of individuals with advanced organ damage. In its earliest manifestations, visceral adiposity predisposes to hypertension and hyperglycemia (metabolic syndrome). In these individuals, ARB therapy delays the progression to chronic hypertension and may also delay the progression to overt diabetes. Based on the increased cardiovascular disease risk of the metabolic syndrome, which is similar to stage 1 hypertension, both lifestyle modification and ARB therapy are justifiable. ARB therapy has also been found to delay the onset of microalbuminuria and retinopathy. In established diabetic nephropathy, ARB therapy is recommended as a standard alternative to angiotensin‐converting enzyme inhibition to reduce macroalbuminuria and delay the progression to end‐stage disease. Finally, large trials in ischemic heart disease, heart failure, and stroke have demonstrated clear benefits of ARB therapy. Because ARBs have side effect rates equal to placebo and far lower than any other antihypertensive drug class, the benefit/risk ratio is highly favorable across the entire spectrum of diabetic disease. Thus, ARB therapy is a highly attractive alternative for individuals at any stage of diabetes and with any pattern of complications. J Clin Hypertens (Greenwich) . 2011;13:290–295. © 2011 Wiley Periodicals, Inc.