| Autor: |
Patel, Vinod, Panja, Srinivas, Venkataraman, Asok |
| Zdroj: |
British Journal of Diabetes & Vascular Disease; Aug2001, Vol. 1 Issue 1, p44-51, 8p |
| Abstrakt: |
BackgroundACE inhibitors have a special role in diabetes care. They have been proven to reduce urinary albumin excretion and reduce the rate of progression of diabetic nephropathy and retinopathy. 1-3 There is proven benefit post myocardial infarction, with a greater beneficial effect in patients with diabetes in comparison to those without. 4 The effect of ACE inhibitors in patients who have low ejection fractions or overt cardiac failure is well described.5 More recent studies indicate other benefits of ACE inhibitors such as improving dyslipidaemia and insulin sensitivity.Cardiovascular disease is the commonest cause of mortality among patients with type 2 diabetes. A recent study reports the standardised mortality ratio to be considerably higher in people with diabetes with the vast majority of the excess due to cardiovascular disease (type 1 diabetes: women x 6.41, men x 2.94, type 2 diabetes: women x 1.6, men x 1.41).6 Patients with type 2 diabetes who have no evidence of previous coronary heart disease were found to be at the same risk of myocardial infarction and cardiovascular death as non-diabetic patients who had already suffered from a myocardial infarction.7The diabetes subject cohort of the HOPE Study, (Heart Outcomes Prevention Evaluation Study), sought to investigate whether ACE inhibitor treatment with ramipril in high-risk patients with diabetes lowers the risk of cardiovascular events.8 Within this main study the MICRO-HOPE substudy investigated the effect of ACE inhibitor treatment with ramipril on microalbuminuria and diabetic retinopathy. 9 The aim of this article is to offer a clinical summary of the above studies and suggest recommendations for clinical practice. [ABSTRACT FROM PUBLISHER] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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