Diabetes mellitus, the renin-angiotensin-aldosterone system, and the heart

Research output: Contribution to journalReview article

Authors

Colleges, School and Institutes

Abstract

With diabetes mellitus reaching epidemic proportions, mainly secondary to obesity, the impact of cardiovascular disease due to this combination makes it a dominant public health problem during the first quarter of the 21 st century. The complex interaction that results in diabetic heart disease is created by overlapping mechanisms. There is a propensity to develop premature,diffuse atherosclerotic coronary disease, which is associated with adverse short- and long-term morbidity and mortality. There are structural and functional abnormalities of the microvasculature, autonomic dysfunction, and intrinsic failure of myocardial contraction (so-called diabetic cardiomyopathy). These changes are amplified by arterial hypertension and kidney disease. In this review, we consider the role of the reninangiotensin-aldosterone system and how it is a crucial driver of most of the pathophysiologic mechanisms behind diabetic heart disease and why in the past 5 years blocking this system in diabetic patients has emerged as a critical therapeutic intervention.

Details

Original languageEnglish
Pages (from-to)1737-1748
Number of pages12
JournalArchives of Internal Medicine
Volume164
Issue number16
Publication statusPublished - 1 Sep 2004