Abstract
Angiotensin-converting enzyme (ACE) inhibitors are the first-line therapeutic agents
for treating hypertension in patients with the cardiometabolic syndrome and those
with diabetes. ACE inhibitor therapy reduces both microvascular and macrovascular
complications in diabetes and appears to improve insulin sensitivity and glucose metabolism.
Several recent studies indicate that ACE inhibitor therapy reduces the development
of type 2 diabetes in persons with essential hypertension, a population with a high
prevalence of insulin resistance. ACE inhibitor therapy has been shown to improve
surrogates of cardiovascular disease (eg, vascular compliance, endothelial-derived
nitric oxide production, vascular relaxation and plasma markers of inflammation, oxidative
stress, and thrombosis) and reduce cardiovascular disease, renal disease progression,
and stroke. This article explores potential mechanism by which ACE inhibition reduces
the development of diabetes, improves these surrogate markers, and reduces cardiovascular
disease and renal disease.
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Article info
Footnotes
☆This work was supported by Grant No. RO1-HL-63904-01 from the National Institutes of Science, and by Grants from the Veterans Administration and the American Diabetes Association (JRS).
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
