Current Hypertension Reviews - Volume 5, Issue 3, 2009

In this “Hot Topic” issue of Current Hypertension Reports we focus on the role of blood pressure control in diabetes and novel aspects of the renin angiotensin system. This issue includes current experimental and clinical evidence and covers important “burning” issues such as, 1. what is the optimal blood pressure target in diabetes and hypertension, 2. is there superiority of inhibitors of the renin angiotensin system (RAS) ove Read More

This review focuses on trials that have examined the relationship between blood pressure (BP) lowering strategies and cardiovascular and renal outcomes in subjects with type 2 diabetes. In particular, we highlight the results of the recently completed BP-arm of the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation) study. Active therapy with perindopril and indapamide Read More

Cardiovascular diseases (CVDs) are the major causes of morbidity and mortality in persons with diabetes, and many factors, including hypertension, contribute to this high prevalence of macrovascular complications. Hypertension is approximately twice as frequent in subjects with diabetes compared with non-diabetic patients. Furthermore, up to 75Y% of CVD in diabetes may be attributable to hypertension, leading to reco Read More

The ONTARGET trial programme tested the effects of the angiotensin AT1 receptor blocker (ARB), telmisartan, alone or in combination with the angiotensin converting enzyme (ACE) inhibitor, ramipril, in more than 25.000 patients at high cardiovascular risk including diabetes on a combined endpoint consisting of cardiovascular death, non-fatal stroke or myocardial infarction and hospitalisation for congestive heart failure. Pat Read More

Type 2 Diabetes Mellitus (T2DM) and hypertension (HTN) both increase cardiovascular disease (CVD) morbidity and mortality, and impose a tremendous burden on worldwide heath care systems in recent years. The mechanisms underlying the frequent coexistence of T2DM and HTN, two main components of the Cardiometabolic Syndrome (CMS), remain to be fully uncovered. Interestingly, both conditions are linked by chr Read More

The renin angiotensin system (RAS) is a key homeostatic regulator that relies on feedback regulation to achieve and sustain the delicate balance required for healthy physiological function. A number of negative feedback loops exist within the RAS that counterbalance the effects of conventional RAS blockade. Indeed, instead of reducing levels of Ang II and aldosterone, exaggerated feedback responses lead to a par Read More

The renin-angiotensin system (RAS) is a major physiological regulator of body fluid volume, electrolyte balance, and arterial blood pressure. The octapeptide, angiotensin (Ang) II, is the main effector of the RAS and overactivity of Ang II is a major contributor to pathological changes in cardiovascular disease; exemplified by the vasoprotective effects observed with RAS inhibition that extend beyond blood pressure reduc Read More

Discovery of (pro)renin receptor uncovered a novel function of renin/prorenin as the receptor ligands in addition to enzyme and its precursor. Binding of renin and prorenin to the (pro)renin receptor activate two major signaling pathways: the locally generatedangiotensin II-dependent pathway as a result of the enzymatic activation of renin/prorenin, and the angiotensin II-independent (pro)renin receptor mediated intra Read More

Diabetic retinopathy affects a significant proportion of people with diabetes. Epidemiological studies suggest that hypertension is related to diabetic retinopathy, and major clinical trials has provided clear evidence that controlling blood pressure in diabetic patients with hypertension reduces the incidence and progression of retinopathy and visual loss. The United Kingdom Prospective Diabetes Study (UKPDS) showed that a 10 m Read More

Blockade of angiotensin II (Ang II) has potential therapeutic benefit for ocular diseases including diabetic retinopathy and retinopathy of prematurity. Perhaps the most studied is diabetic retinopathy where angiotensin converting enzyme inhibition and angiotensin type 1 receptor blockade (AT1-RB) is beneficial. The importance of Ang II has recently been highlighted with DIRECT (DIabetic REtinopathy Candesartan Read More