Permissive role of hypertension in the development of proteinuria and progression of renal disease in insulin-dependent diabetic patients

Earle, Kenneth; Morocutti, Anna; Viberti, Giancarlo

doi:10.1097/00004872-199715020-00010

Cited by 7 publications

(1 citation statement)

References 30 publications

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“…Antihypertensive therapy targeting tight BP control at an early stage in the natural history can prevent the progression of each stage of diabetic nephropathy and is associated with improved survival. 30,31 There is also compelling evidence that ACE inhibition can complement the effects of BP control and further delay the progression of renal disease in Type 1 diabetes, especially in patients with proteinuria ≥1 g/day (see below).…”

Section: Type 1 Diabetes Mellitus and Proteinuriamentioning

confidence: 99%

Review: Calcium channel blockade in combination with angiotensin-converting enzyme inhibition or angiotensin II (AT1-receptor) antagonism in hypertensive diabetics and patients with renal disease and hypertension

Swales

Williams

2002

J Renin Angiotensin Aldosterone Syst

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Effective reduction in blood pressure (BP) improves survival and morbidity in hypertensive patients. Combination therapy with multiple antihypertensive agents is frequently required in clinical practice and therapeutic trials to achieve target BP. Patients at elevated cardiovascular risk achieve the greatest benefit from equivalent reduction in BP and also require more stringent BP control. In patients with hypertension and diabetes mellitus or renal disease, BP control is of primary importance and blockade of the renin-angiotensin system (RAS) should be the initial therapeutic intervention. Choice of combination therapy has been insufficiently studied in major clinical cardiovascular endpoint trials. Diuretic therapy remains the logical addition to RAS blockade. Despite previous debate, the available evidence suggests long-acting calcium-channel blockers are also a safe and very effective addition to improve BP control further. The choice of antihypertensive combination therapy should not override the fundamental necessity of lowering BP to target levels.

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Section: Type 1 Diabetes Mellitus and Proteinuriamentioning

confidence: 99%