Journal Article

Cardiorenal End Points in a Trial of Aliskiren for Type 2 Diabetes

Desai, Akshay S, Haffner, Steven M, Brunel, Patrick, McMurray, John J.V, de Zeeuw, Dick, Nicolaides, Maria, Pfeffer, Marc A, Parving, Hans-Henrik, Richard, Alexia, Brenner, Barry M, Chaturvedi, Nish, Xiang, Zhihua, Solomon, Scott D, Persson, Frederik

2012

Overview

Patients with type 2 diabetes at high risk for cardiovascular disease who were already taking a renin–angiotensin system blocker were randomly assigned to the direct renin inhibitor aliskiren or placebo. The study was discontinued early for no benefit, or even possible harm. Mortality associated with type 2 diabetes remains nearly twice that when diabetes is absent. 1 Complications of diabetes, particularly renal and cardiovascular disease, substantially increase the risk of subsequent severe illness and death. When a patient has both renal and cardiovascular disease, the risk is magnified further. 2 , 3 Blood-pressure lowering is beneficial in slowing renal-disease progression, reducing cardiovascular disease events, and preventing premature death. 4 Renin–angiotensin–aldosterone system (RAAS) blockers are highly effective, with apparent benefits extending beyond simple blood-pressure lowering 5 – 8 ; such agents have become the preferred first-line interventions in high-risk persons with diabetes. Theoretically, dual RAAS blockade should be more . . .

• Publisher: Massachusetts Medical Society
• Subject: Aged / Amides - adverse effects / Amides - therapeutic use / Angiotensin Receptor Antagonists - therapeutic use / Angiotensin-converting enzyme inhibitors / Angiotensin-Converting Enzyme Inhibitors - therapeutic use / Antihypertensive Agents - adverse effects / Antihypertensive Agents - therapeutic use / Biological and medical sciences / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - epidemiology / Cardiovascular Diseases - mortality / Cardiovascular Diseases - prevention & control / Cerebral infarction / Coronary artery disease / Creatinine / Diabetes / Diabetes mellitus / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - drug therapy / Diabetes. Impaired glucose tolerance / Dialysis / Double-Blind Method / Drug Therapy, Combination / End-stage renal disease / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / Etiopathogenesis. Screening. Investigations. Target tissue resistance / Female / Follow-Up Studies / Fumarates - adverse effects / Fumarates - therapeutic use / General aspects / Heart attacks / Heart diseases / Humans / Hyperkalemia / Hyperkalemia - chemically induced / Hypokalemia / Hypotension / Kidney diseases / Kidney Diseases - epidemiology / Kidney Diseases - etiology / Kidney Diseases - prevention & control / Kidney transplantation / Male / Medical sciences / Middle Aged / Myocardial infarction / Patient Dropouts / Renal failure / Renin / Renin - antagonists & inhibitors / Stroke / Treatment Failure / Women