Department of Medicine, University of California in San Francisco (Fresno-MEP), 155 North Fresno Street, Fresno, CA 93701, USA.
Curr Cardiol Rep. 2010 Nov;12(6):464-71. doi: 10.1007/s11886-010-0138-1.
Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease (CVD) morbidity and mortality worldwide. Renin-angiotensin system (RAS) blockers have been indispensable in diminishing the macrovascular and microvascular complications of diabetes. In addition, cumulative evidence from retrospective studies pointed toward a beneficial effect of RAS agents in preventing the development and progression of T2DM. This disease-modifying potential of RAS blockers has been substantiated by recent prospective trials. Contemporary concepts regarding the natural history of T2DM and the pathophysiologic processes involved have increased our understanding of the mechanisms underlying the therapeutic potential of these agents in diabetes management. In addition to their established roles in the primary prevention of CVD in patients with diabetes, RAS blockers might be considered a suitable therapeutic choice for preventing the development of frank diabetes in high-risk patients.
2 型糖尿病（T2DM）是全球心血管疾病（CVD）发病率和死亡率的主要危险因素。肾素-血管紧张素系统（RAS）阻滞剂在减少糖尿病的大血管和微血管并发症方面不可或缺。此外，来自回顾性研究的累积证据表明，RAS 药物在预防 T2DM 的发生和进展方面具有有益作用。最近的前瞻性试验证实了 RAS 阻滞剂的这种疾病修饰潜力。关于 T2DM 的自然病史和涉及的病理生理过程的现代概念增加了我们对这些药物在糖尿病管理中治疗潜力的机制的理解。除了在糖尿病患者的 CVD 一级预防中发挥既定作用外，RAS 阻滞剂也可被视为预防高危患者发生显性糖尿病的合适治疗选择。
