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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.
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.
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.