What is the impact of blood-pressure control on cardiovascular events in patients with diabetic nephropathy?

Giuseppe Mancia

This article has no abstract so we have provided the first paragraph of the full text.

Berl et al. have conducted a further analysis of data from the IDNT on the nephroprotective and cardiovascular effects of amlodipine and irbesartan.^{1, 2} Their results confirm the conclusions reached by similar post hoc analyses of trials in diabetic patients with hypertension,³ strengthening the recommendations of international guidelines for a target SBP of <130 mmHg in such individuals.⁴ The findings also extend previous knowledge on two issues. First, they indicate that SBP <130 mmHg delays progression to end-stage renal disease and reduces the incidence of cardiovascular complications in subjects with diabetic nephropathy. Second, the results reveal a direct relationship between SBP and the incidence of CHF in diabetic patients with hypertension. In the current paper, the incidence of CHF was lower in patients who received irbesartan than in those given amlodipine, although both achieved the same SBP. Overall, protection against CHF was due in approximately equal amounts to the reduction in blood pressure per se and the type of antihypertensive employed. Clearly, achieving blood-pressure control in this setting does not eliminate the importance of how such control is achieved. Interestingly, a previous report from the IDNT showed that the risk of MI was reduced more substantially by amlodipine than irbesartan.

ARTICLE NAVIGATION - ARTICLE TOOLS

• Full text
• Download PDF
• Send to a friend
• PDA services
• Permissions

ISSUE NAVIGATION - THIS ISSUE

• Table of Contents
• Previous article
• Next article