1Medical Research/Tokushima University, Tokushima, Japan
2Japan Low Carbohydrate Diet Promotion Association (JLCDPA), Kyoto, Japan
Corresponding Author: Hiroshi BANDO, MD. PhD, FACP
Address: Medical Research/Tokushima University, Nakashowa 1-61, Tokushima 770-0943, Japan; Tel: +81-90-3187-2485; Fax: +81-88-603-1030; E-mail: firstname.lastname@example.org
Received date: 05 April 2020; Accepted date: 10 April 2020; Published date: 16 April 2020
Citation: Bando H. Recommended Management of Hypertensive Patients with Diabetes for Renin-Angiotensin System (RAS) Inhibitors. Diab Res Open Access. 2020 Apr 16;2(1):4-8.
Copyright © 2020 Bando H. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Hypertension; Diabetes Mellitus; Renin-Angiotensin System (RAS) Inhibitors; Angiotensin-Converting Enzyme (ACE) Inhibitors; Angiotensin Receptor Blockers (ARB)
Abbreviations: RAS: Renin-Angiotensin System; ACE: Angiotensin-Converting Enzyme; ARB: Angiotensin Receptor Blocker; CCB: Calcium Channel Blocker; ACC/AHA: American College of Cardiology/American Heart Association; ESC/ESH: European Society of Cardiology and European Society of Hypertension
Currently, major categories of antihypertensive agents include diuretics, beta-blockers, calcium channel blockers (CCBs), renin-angiotensin system (RAS) inhibitors [angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB)]. Among them, RAS (ACE inhibitors and ARB) would be recommended to be a first-line treatment when providing antihypertensive agents for hypertensive patients with diabetes, cardiovascular disease, and impaired renal function. Randomized controlled trials (RCT) of RAS inhibitors compared with other antihypertensive showed a rather lower relative risk (RR). They are all-cause death (RR - 0.95), cardiovascular death (RR - 0.84), incidence of cardiovascular disease (RR - 0.93), and incidence of renal dysfunction (RR - 0.91).