1. Renin-Angiotensin-Aldosterone System Inhibition
- Author
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Jason I. Biederman, Holly Smith, and Kelly Mercier
- Subjects
Angiotensin receptor ,Angiotensin II receptor type 1 ,Aldosterone ,biology ,business.industry ,Angiotensin-converting enzyme ,Pharmacology ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,chemistry.chemical_compound ,Mineralocorticoid receptor ,chemistry ,Diabetes mellitus ,Renin–angiotensin system ,biology.protein ,Medicine ,Pharmacology (medical) ,Microalbuminuria ,business - Abstract
Angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy in hypertensive diabetic patients with macroalbuminuria, microalbuminuria, or normoalbuminuria has been repeatedly shown to improve cardiovascular mortality and reduce the decline in glomerular filtration rate. Renin-angiotensin-aldosterone system (RAAS) blockade in normotensive diabetic patients with normoalbuminuria or microalbuminuria cannot be advocated at present. Dual RAAS inhibition with ACE inhibitors plus ARBs or ACE inhibitors plus direct renin inhibitors has failed to improve cardiovascular or renal outcomes but has predisposed patients to serious adverse events.
- Published
- 2014
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