 |
|
 |
- December 1, 2008 |
|
|
Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
|
|
|
| Presentation |
|
"Renin-Angiotensin System: Beyond the Kidney"Prof. Mark E. Cooper (biography)
English - 2006-09-01 - 28 minutes
|
 | (45 slides) |
Summary :
In this presentation Prof. Cooper talks about effects of the renin-angiotensin system in the vasculature, the retina and the pancreatic beta cell.
Diabetes is associated with accelerated atherosclerosis, for which elevated blood pressure is one risk factor. How would the renin-angiotensin system be implicated in this increased risk? Angiotensin II raises blood pressure by acting as a vasoconstrictor, and it also affects smooth muscle growth and promotes the infiltration of inflammatory cells. As seen in the HOPE and EUROPA clinical trials, ACE inhibitor treatment was associated with reduced cardiovascular events. ACE inhibitor treatment has further been shown to reduce atherosclerosis in animal models of diabetes (1). This effect seems to be independent of blood pressure reduction, as a calcium channel blocker did not have the same effect (2).
"Diabetic retinopathy remains a very common problem in the diabetic patient," says Prof. Cooper "and remains the leading cause of blindness in the working age population." The retina has a renin-angiotensin system and there is evidence from animal studies to suggest that blockade of the renin-angiotensin system reduces retinal blood vessel proliferation (3,4). The EUCLID and UKPDS clinical trials further showed that ACE inhibitor therapy was associated with a reduction in the development of retinopathy.
Lastly Prof. Cooper talks about the renin-angiotensin system and the beta cell. Administration of angiotensin receptor blockers or ACE inhibitors has been associated reductions in the incidence of new-onset type 2 diabetes (5). Is this due to a benefit of blocking the renin-angiotensin system? Prof. Cooper describes some animal studies reported by Tikellis et al. from the Baker Medical Research Institute, indicating mechanisms which could possibly explain the protective effect of renin-angiotensin system blockade against new onset diabetes (6).
Copyright © 2006 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
Clinical and experimental evidence for extra-renal benefits of renin-angiotensin system (RAS) blockade in the:
- Vasculature
- Retina
- Pancreas
Bibliographic references :
1. Riccardo Candido, MD; Karin A. Jandeleit-Dahm, MD, PhD; Zemin Cao, MD; Stefan P. Nesteroff;; Wendy C. Burns, BSc, (Hons), BEd; Stephen M. Twigg, MBBS, FRACP, PhD; Rodney J. Dilley, PhD; Mark E. Cooper, MBBS, FRACP, PhD; Terri J. Allen, PhDPrevention of Accelerated Atherosclerosis by Angiotensin-Converting Enzyme Inhibition in Diabetic Apolipoprotein E–Deficient Mice Circulation. 2002;106:246.
2. Riccardo Candido, MD; Terri J. Allen, PhD; Markus Lassila, PhD; Zemin Cao, MD; Vicki Thallas, BSc; Mark E. Cooper, MBBS, FRACP, PhD; Karin A. Jandeleit-Dahm, MD, PhDIrbesartan but Not Amlodipine Suppresses Diabetes-Associated Atherosclerosis Circulation. 2004;109:1536-1542.
3. Christina J. Moravski; Darren J. Kelly; Mark E. Cooper; Richard E. Gilbert; John F. Bertram; Shahnaz Shahinfar; Sandford L. Skinner; Jennifer L. Wilkinson-Berka Retinal Neovascularization Is Prevented by Blockade of the Renin-Angiotensin System Hypertension. 2000;36:1099.
4. Sarlos et al. Am J Pathol 2004.
5. Jandeleit-Dahm, Karin AM; Tikellis, Christos; Reid, Christopher M; Johnston, Colin I; Cooper, Mark EWhy blockade of the renin-angiotensin system reduces the incidence of new-onset diabetes. Journal of Hypertension. 23(3):463-473, March 2005.
6. Tikellis C, Wookey PJ, Candido R, Andrikopoulos S, Thomas MC, Cooper ME.Improved Islet Morphology after Blockade of the Renin- Angiotensin System in the ZDF Rat Diabetes 53:989-997, 2004.
|
|
|
|
|
|
| Search our website |
 |
| |
Would you like to know more about insulin resistance? Are you looking for information pertaining to Type 2 Diabetes? You can find what you are looking for in over 2000 references available on CMEonDiabetes. |
| |
|
|
| Social |
|
| |
Let others know about this presentation.
|
|
|
|
