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The distribution of fat within the body, particularly visceral fat is an important determinant in the development of various cardiovascular and metabolic disorders, and is influenced by angiotensin II and the renin–angiotensin system. Given these issues, this Article examines he relationship of obesity to cardiovascular disease and metabolic syndrome and the effectiveness of obesity management.
The definition of this syndrome, its utility as a predictor of cardiovascular risk, and the treatment implications of diagnosis remain unsettled. In this Article, de Zeeuw and Bakker argue that, while the most commonly used definitions of the metabolic syndrome perform poorly in estimatation of cardiovascular risk, the concept is nonetheless useful.
The metabolic syndrome is a major public-health concern worldwide, and the Japanese are attempting to address the issue at a national level. Their criteria for this syndrome, in contrast to various others, include measurement of waist circumference. Here, Fujita discusses country-specific impact of the metabolic syndrome, using the evolution of the Japanese diagnostic criteria as a model.
Proliferator-activated receptor-γ has a key role in glucose and lipid metabolism and activation lead to benefits in patients with diabetes. Telmisartan can robustly activate this nuclear receptor as well as blocking the angiotensin II type 1 receptor. This Article assesses whether this dual effect affords telmisartan additional benefits over other angiotensin-II-receptor blockers.
Cardiovascular mortality and morbidity remain high despite a variety of therapies being available. New avenues for therapy are, therefore, continually sought. Here, whether the relationship that exists between cardiovascular and renal disease could provide such an opportunity is discussed, in the context of treatment strategies directed at the renin–angiotensin–aldosterone system.
Proteinuria is a useful early marker for progressive renal dysfunction. Angiotensin II is centrally involved in all stages of renal pathophysiology, and angiotensin-II-receptor blockers can be useful therapeutic agents in preventing the development of overt kidney disease. This Article discusses the role of angiotensin II in cardiovascular and renovascular disease, and the effectiveness of angiotensin-II-receptor blocker therapy.
