Cardiovascular disease in patient with kidney disease caused by diabetes
DOI:
https://doi.org/10.47196/diab.v51i3.111Keywords:
atherosclerotic heart disease, blood pressure, angiotensin-converting enzyme inhibitors, angiotensin receptor blocker, calcium channel inhibitors, nephroprotectionAbstract
Most of the patients with diabetes and hypertension should be treated with a systolic blood pressure <140 mmHg/ and diasto- lic BP of <90 mmHg. Lower levels of BP <130/80 mmHg can be adequate in patients with high risk of heart and kidney diseases. Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARA II) at maximum tolerated doses are considered first line drugs in the treatment of hypertension, in diabetic patients with a rate of albuminuria/creatininuria >30 mg/g serum creatinine, the level of glomerular filtration and the level of potassium should be monitored. Different studies observe with these drugs, nephroprotection regardless of the reduction of attained blood pressure. It is not recommended to use a of ACEI and ARA II combination. Calcium channel inhibitors are safe drugs for the treatment of hypertension in diabetic patients, with kidney insufficiency.
References
Cardiovascular disease and risk management. Standars of medical care. Diabetes Care 2017; 40 (Suppl 1):S57-S87.
Chobanian A. Hypertension in 2017: what is the right target? JAMA 2017; 317(6):579-580.
The ACCORD study group. N Engl J Med 2010; 362:1575- 1585.
Mc Brien K, Rabi DM, Campbell N, et al. Intensive and standard blood pressure targets in patients with type 2 diabetes mellitus: systematic review and meta-analysis. Arch Intern Med 2012; 172(17):1296-1303.
Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-converting-enzyme inhibition on diabetic ne- phropathy.The Collaborative Study Group.The Collabora- tive study group. N Engl J Med 1993; 329(20):1456-62.
Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators. Lancet 2000; 355 (9200):253-9.
Brenner BM, Cooper ME, de Zeew D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345: 861-869.
Lewis EJ , Hunsincker LG, Clarke WH, Berl T, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345:851-860.
Parving HH, Lehnert H, Bröchner-Mortensen J, et al. The microalbuminuric study group. The effects of irbersartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 345: 870-878.
The ONTARGET investigators. Telmisartan, ramipril, or both in patients at high risk of vascular events. N Engl J Med 2008; 358:1547-49.
The VA NEPHRON investigators. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med 2013; 369:1892-903.
Cheng J, Zhang W, Zhang X, et al. Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor bloquers on all cause mortality, cardiovascular deaths and cardiovascular events in patients with dia- betes mellitus: a meta-analysis. JAMA Intern Med 2014; 174(5)773-85.
Hao G, Wang Z, Guo R, et al. Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: a meta-analisis of randomized controlled studies. BMC Cardiovasc Disord 2014; 14:148.
McMurray JJ, Milton Packer M, Desai S; The PARA- DIGM HF investigators. Angiotensin-neprilysin inhibition vs enalapril in heart failure. N Engl J Med 2014; 371:993-1004.
Seferovic JP, Claggett B, Seidelman SB, et al. Effects of sacubitril/valsartan vs enalapril on glycemic control in patients with heart failure and diabetes: a post hoc analysis from the PARADIGM-HF trial. Lancet Diabetes Endocrinol 2017; 5 (5):333-340.
Jamerson K, Weber M, Bakris G; The ACCOMPLISH trial investigators. Benazepril plus amlodipine or hydroclorothiazide for hypertension in high risk patients. N Engl J Med 2008; 359(4)2417-28.
Dahlof B, Server PS, Poulter NR, et al. The Ascot investi- gators: Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required vs atenolol adding bedroflumethiazide as required in the Anglo Scandinavian Cardiac Outcomes- Trial Blood pressure lowering arm (ASCOT-BPA): a mul- ticenter randomised controled trial. Lancet 2005; 366 (9489):895-906.
Lindholm LH, Ibsen H, Dahlof B; The LIFE Study group. Cardiovascular morbidity and mortality in patients with diabetes in the losartan intervention for end point reduction in hypertension study (LIFE): A randomised trial against atenolol. Lancet 2002; 359 (9311):1004-10.
UK prospective study group. Tight blood pressure and risk of macrovascular and microvascular complications in type 2 diabetics. BMJ 1998; 317:703-713.
Hansson L, Lindholm LH,Niskanen L, et al. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbi- dity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet 1999; 353(9153):611-6.
Bakris G, Fonseca V, Katholi, et al. Metabolic effect of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension. JAMA 2004; 292(18):2227-2583.
Nissen SE, Wolsky K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med 2007; 356:2457-71.
Food and Drug Administration U.S Department of Health and Human Services. Center of Drug Evaluation and Research. December 2008: Guidance for industry. Diabetes mellitus: evaluating cardiovascular risk in new antidiabetic therapies to treat type 2 diabetes.
Green JB, Bethel MA, Armstrong PW, et al.; The Te- cos Study group. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N Engl J Med 2015; 373:232-42.
Scirica B, Bhatt D, Banwald E, Steg G, Davidson J, Hirshberg B; the Savor Timi Steering Committe and Investi- gators. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med 2013; 369:1317-1326.
Filion K, Azoulay L, Platt R, et al; the CNODES Investiga- tors. A multicenter observational study of incretin based drugs and heart failure. N Engl J Med 2016; 374:1145- 1154.
Marso SP, Daniels GH, Brown-Frandsen K; the Leader Steering Committee. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375:311-322.
Marso SP, Brain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375:1834-44.
Zinman B, Wanner Ch, Lachin J, et al. Empaglifozin, car- diovascular outcomes and mortality in type 2 diabetes. N Engl J Med 2015; 373(22):2117-2128.
Wanner Ch, Inzucchi S, Lachi, et al. Empaglifozin and progession of kidney disease in type 2 diabetes. N Engl J Med 2016; 37:323-334.
Neal B, Perkovic V, Mahaffey KW, et al. Canaglifozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med jun 2017( en impresión).
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.
La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.
Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.
