Angiotensin-Converting Enzyme Inhibitors vs. Angiotensin Receptor Blockers for the Treatment of Hypertension in Adults With Type 2 Diabetes: Why We Favour Angiotensin Receptor Blockers

Publication date: April 2018Source: Canadian Journal of Diabetes, Volume 42, Issue 2Author(s): Thomas A. Mavrakanas, Mark L. LipmanAbstractCardiovascular disease is the principal cause of morbidity and mortality in patients with diabetes mellitus. The incidence or progression of kidney disease is also common in these patients. Several clinical trials have established the efficacy of angiotensin receptor blockers for the prevention of adverse cardiovascular and renal outcomes in this population and are summarized in this review article. Head-to-head comparison of angiotensin receptor blockers with angiotensin-converting enzyme inhibitors has shown similar cardioprotective and renoprotective properties of both medication classes. However, angiotensin receptor blockers have an improved safety profile with fewer episodes of cough and angioedema and may be the agent of choice in patients with diabetes and hypertension. Novel therapeutic strategies, such as those that include a mineralocorticoid receptor blocker or a selective sodium-glucose cotransporter type 2 inhibitor, may further protect patients with diabetes from cardiovascular and renal complications.RésuméLes maladies cardiovasculaires sont la principale cause de morbidité et de mortalité chez les patients atteints de diabète sucré. L'incidence ou la progression de la maladie rénale est également fréquente chez ces patients. Dans le présent article de re...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research

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RARITAN, N.J., March 20, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that it will unveil late-breaking data from its leading cardiovascular and metabolism portfolio during the virtual American College of Cardiology’s 69th Annual Scientific Session together with the World Congress of Cardiology (ACC.20/WCC) on March 28-30, 2020. Notably, four late-breaking abstracts for XARELTO® (rivaroxaban) will be presented, including data from the Phase 3 VOYAGER PAD study in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization.Click to ...
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
Staphylococcal scalded skin syndrome (SSSS) is an exfoliative skin syndrome that occurs as a reaction to an exotoxin released by Staphylococcus aureus, and most commonly occurs in children and adults with renal failure or immunocompromised. Patients can have variation of severity, from localized blisters to generalized skin exfoliation involving all body surfaces. SSSS can be life-threating and should be diagnosed and treated promptly. This is a case of 51 y/o woman with hypertension, type 2 diabetes mellitus, cardiomyopathy, and renal failure for which has been receiving hemodialysis (HD) for the past 4 years that present...
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
A 63-year-old man presented to the emergency department with 5 days of headache, chills, cough, and diffuse myalgias and 1 day of fever to a temperature of 39.9 °C. His history was significant for type 2 diabetes mellitus, coronary artery disease, hypertension, obstructive sleep apnea, and corticosteroid injection 2 months previously for chronic L4 discogenic radiculopathy. Three days before emergency department presentation he had contacted his primary ca re physician, who prescribed oseltamivir over the phone.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' clinic Source Type: research
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 75-year-old man is seen for routine follow-up for very severe COPD. He has constant dyspnea and air hunger and spends most of the day in a chair. He has had no change in baseline cough and sputum production. He has had multiple COPD exacerbations that required ICU admission and intubation. He has not benefited from pulmonary rehabilitation in the past. He quit smoking 3 years ago. His medical history is also notable for hypertension, type 2 diabetes mellitus, and a myocardial infarction 3 years ago. Hi...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Palliative Care Pulmonology Source Type: blogs
Publication date: Available online 22 December 2017 Source:Canadian Journal of Diabetes Author(s): Thomas A. Mavrakanas, Mark L. Lipman Cardiovascular disease is the principal cause of morbidity and mortality in patients with diabetes mellitus. Incidence or progression of kidney disease is also common among these patients. Several clinical trials have established the efficacy of angiotensin receptor blockers for the prevention of adverse cardiovascular and renal outcomes in this population and are summarized in this review article. Head to head comparison of angiotensin receptor blockers with angiotensin converting enzyme...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
A 73-YEAR-OLD MALE with a medical history of hypertension, type-2 diabetes mellitus, obesity, and gout was transferred to the authors ’ facility with a 2-month history of increasing dyspnea, recurrent right pleural effusions, and a mediastinal mass of indeterminate etiology after a computer tomography-guided biopsy and thoracentesis. Although previously active, he had experienced decreased exercise tolerance, manifested by an in ability to walk 5 steps without stopping to catch his breath. He also reported orthopnea, cough, peripheral edema, weight loss, and fatigue.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Conference Source Type: research
Conclusion The mortality rate in our study was 8.6%. H1N1 influenza patients who were older with deranged hepatic parameters and raised total leukocyte count had poor prognosis.
Source: Current Medicine Research and Practice - Category: Journals (General) Source Type: research
A 45-year-old woman with a history of medication-controlled essential hypertension, stage 2 chronic kidney disease, type 2 diabetes mellitus, and a pack-a-day cigarette habit presented less than 60 minutes after acute onset of severe shortness of breath that awoke her from sleep. She had felt well the previous day, and went to bed with no complaints.   Around 4 a.m., she woke up from sleep very dyspneic, with moderate chest “discomfort” over her left chest that radiated to her back and was unchanged by position or respirations. She denied other symptoms such as fever, cough, nausea, vomiting, numbness, o...
Source: Spontaneous Circulation - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
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