Key result
Early BP-lowering therapy delays or prevents microalbuminuria onset in diabetic patients.
Why the study?
It is unclear whether earlier intervention with blood-pressure lowering agents in patients with type 2 diabetes can prevent or delay the onset of renal or systemic vascular disease.
Does early intervention with blood-pressure lowering agents prevent or delay the onset of microalbuminuria in patients with type 2 diabetes?
Does early intervention with blood-pressure lowering agents prevent or delay the onset of microalbuminuria in patients with type 2 diabetes?
This review highlights the utility of microalbuminuria as a surrogate marker for cardiovascular and renal events in early-stage type 2 diabetes and discusses interventions to prevent its onset.
Unclear whether early BP lowering prevents renal complications in diabetes without target organ damage; leaves open need for dedicated RCTs.
Cardiovascular and chronic kidney disease are epidemic throughout industrialized societies. Diabetes leads to premature cardiovascular disease and is regarded by many as the most common etiological factor for chronic kidney disease. Because most studies of blood-pressure lowering agents in people with diabetes and hypertension have been conducted in individuals who already have some target organ damage, it is unclear whether earlier intervention could prevent or delay the onset of renal or systemic vascular disease. In early disease there is only a low possibility of observing cardiovascular or renal events; thus intervention trials in this population must rely on disease markers such as microalbuminuria. Accordingly, the authors review the evidence to support the use of microalbuminuria as a disease marker in diabetic patients based on its strong association with renal and cardiovascular events, and discuss recent trials that examine the impact of preventing or delaying the onset of microalbuminuria.
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Ruilope et al. (2010) conducted a review in Type 2 Diabetes. Microalbuminuria prevention strategies was evaluated. This review discusses evidence supporting microalbuminuria as a disease marker in diabetic patients and examines recent trials on preventing or delaying its onset.
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