Luis Ruilope

..Not all available antihypertensives are equally effective in controlling BP over 24 hours, and some may exacerbate underlying metabolic abnormalities...

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..The control of other associated risk factors is also required, in particular smoking and lipids...

..All these facts led to the conclusion that both ACE-Is and ARBs can be considered when both renal and cardiovascular protection are aimed for in Type 2 diabetic patients...

..Prevention and protection of renal and cardiovascular damage in these patients will be one of the most relevant tasks in the future...

..Eprosartan is safe, effective and well-tolerated in long-term treatment, either as a monotherapy or in combination with other antihypertensive drugs such as hydrochlorothiazide...

..Besides this, strict control of associated cardiovascular risk factors is also required...

..However, by attaining normal blood pressure levels (< 130/80 mm Hg), better preservation of glomerular filtration rate does not seem to be insured...

..Unlike ACE inhibition, ARB treatment leads to no initial reduction in GFR, thus valsartan may be a better agent for the control of BP, with greater renal protection...

..Preventing or delaying the progression of renal disease from microalbuminuria to nephropathy, and ultimately, to ESRD is thus a crucial goal of DM management...

..The results from INSIGHT support incorporating nifedipine GITS in the management of high-risk hypertensive patients to prevent atherosclerosis-related illness and death...

..The parameters commonly used to evaluate renal function have to be considered in any stratification of cardiovascular risk in hypertensive and heart failure patients...

..For this reason, the predictive capacity of uric acid could be partly dependent on the fact that hyperuricemia runs in parallel with a deranged renal function...

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..Such enhanced suppression might be of benefit for patients exhibiting a progressive decline in renal function because of chronic renal disease...

..The question remains for the time being largely unanswered...

..Renal outcome is also improved by ACE inhibition after an MI. Finally, renal and cardiovascular outcome seem to run in parallel in all these situations...

..Prevention and protection of renal and cardiovascular damage in these patients will be one of the most relevant healt care tasks in the future...

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..The ROADMAP study will answer the question whether an ARB can prevent or delay the onset of microalbuminuria and whether this translates into protection against cardiovascular events and renal disease...

..Recent antihypertensive treatment guidelines recommend greater use of combination therapies...

..The high prevalence of chronic kidney disease in the general and in the hypertensive populations implies the need for an integrative therapeutic approach to fully protect renal and cardiovascular systems simultaneously...

..The fixed combination of perindopril/indapamide can greatly help clinicians in achieving the above goals, using Preterax in the early and BiPreterax in the late stages of nephropathy...

..This paper briefly reviews the most recent evidences about pharmacologic therapies in high-risk patients, focusing on benefits related to improvement of cardiovascular risk factors in hypertensive patients with chronic kidney disease...

..CONCLUSION: Long-term administration of high doses of telmisartan seems to improve the efficacy of the drug to decrease proteinuria and slow the progression to end-stage renal failure in nondiabetic hypertensive renal disease...

..The present study was designed for assessment of control rates of blood pressure in patients with CRI. Secondary objectives included evaluation of the control rates of proteinuria and cardiovascular comorbidities...

..To test the hypothesis that rosiglitazone combined with metformin provides a greater reduction in microalbuminuria and blood pressure than metformin and glyburide at comparable levels of glycemic control...

..In addition, combination therapy resulted in a trend towards more favourable outcomes with respect to pro-thrombotic and proinflammatory markers than amlodipine alone...

..ARBs decrease overall risk of CV and end-organ disease, CVD-related mortality, and cerebrovascular events in patients with hypertension...

..The central role of the renin-angiotensin-aldosterone system (RAAS) in hypertension and renal disease has led to interest in the ability of RAAS-blocking agents to provide benefits beyond blood pressure control...

..This analysis assessed the impact of rimonabant on blood pressure in the pooled population from four large trials with similar design - the Rimonabant-In-Obesity (RIO) programme...

..Arterial hypertension is an insulin-resistant condition that has been associated with an increased incidence of diabetes. We assessed the prevalence of glucose abnormalities in a population of patients with essential hypertension...

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..This combination can be considered as an effective therapy for the diabetic hypertensive population...

..When given in addition to an ACE inhibitor (dual blockade), reductions in UAE of 25-35% relative to ACE inhibitor monotherapy have been found...

..The aim of this study was to analyze the effects of renin-angiotensin system (RAS) blockade on renal endothelial function...

..Suppression of the rennin-angiotensin-aldosterone system should also be considered in any patient with chronic kidney disease, in particular if albuminuria is present...

..This review discusses the role of RAS in the relationship between obesity, essential hypertension and insulin resistance...

..Guidelines, therefore, have recommended these drug classes for the treatment of hypertensive patients with LVH...

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..There is a lack of data on the effects of angiotensin-receptor blocker and diuretic combinations on ambulatory blood pressure (ABP) in hypertensive patients with additional cardiovascular risk factors...

..7-52.5). CONCLUSIONS: The control of the CVRF considered in primary care attended population is insufficient. Hardly one of each 2 patients with HT, DM2 and HC is under control. The overweight and sedentarism control is still poorer...

..Both ACE-I and ARB were titrated as monotherapy up to the maximal recommended dose...

..Our results suggest that nifedipine could be considered as first-line therapy for hypertensive diabetics...

..The present study assessed the prevalence, awareness, treatment and control of hypertension among the elderly population of Spain...

..Patients with type-2 diabetes have a high prevalence of hypertension and show an elevated incidence of cardiovascular events and nephropathy...

..This effect may be mediated by an NO-dependent mechanism, probably through the protective effect of NAC on NO oxidation...

..Stratification of population groups according to cardiovascular risk level is recommended for primary prevention...

..Epidemiologic information suggests that renal and cardiovascular outcome run parallel in this segment of the population...

..With the aim to determine the efficacy and tolerability of this drug in usual clinical practice we performed the ELYPSE trial...

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..When the blood pressure target was not reached, the two strategies tested seem to contribute similarly to further reductions in blood pressure and albuminuria...

..To examine the long-term effects of the angiotensin type I (AT1) receptor antagonist, valsartan, on fibrinolytic balance, coagulation parameters, endothelial function and structural alterations in atherosclerotic rabbits...

..The aim of this paper is to briefly review the evidence in favor of uptitration of either class of inhibitors of the renin-angiotensin system as compared with the combination of the two for the control of either BP or proteinuria...

..Agents that interfere with the renin-angiotensin system, particularly angiotensin-receptor blockers, may have particular benefits on end-organs in diabetic patients...

..This paper describes the detection, prevalence and relevance of minor alterations in the stratification of cardiovascular risk in the hypertensive patient...

..To assess this role of renal function in more detail, we studied the evolution of renal function and the relationship of renal function with mortality and morbidity in the Intervention as a Goal in Hypertension Treatment (INSIGHT) study...

..In addition, an overview of stroke pathogenesis is given and its relationship with treatment action mechanisms reviewed...

..This review examines the relevance of the development of chronic kidney disease in long-term hypertensive patients on the cardiovascular prognosis...

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..Patients at high risk, with diabetes or proteinuria, warrant focused attention. Moreover, a more aggressive behavior of doctors treating uncontrolled hypertension is needed...

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..Hyperuricemia has been shown to be associated with an increased risk of cardiovascular disease in hypertensive patients in some but not in all epidemiological studies in which this relationship has been investigated...

..Therefore, in patients not controlled with monotherapy, doxazosin GITS can be considered an alternative to the addition of thiazide diuretics...

..Long-term studies are required to determine the relevance of development of new-onset diabetes in treated hypertensive patients...

..It appears that the profile of patients with a poorer therapeutic response includes a greater severity of hypertension and/or the presence of cardiovascular disease...