Lido P, Romanello D, Tesauro M, Bei A, Perrone M A, Palazzetti D, Noce A, Di Lullo L, Calò L, Cice G
Italian Medicines Agency (AIFA), Rome, Italy.
Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1524-1534. doi: 10.26355/eurrev_202203_28217.
Patients with diabetes mellitus (DM) often present other chronic comorbidities including arterial hypertension (AH), chronic kidney disease (CKD), ischemic heart disease (IHD) and heart failure with preserved ejection fraction (HFpEF). The frequent association of the latter conditions is considered part of the spectrum of cardio-renal syndromes (CRS), a group of disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. Verapamil is a non-dihydropyridine calcium channel blocker (CCB) widely used in the treatment of hypertension, chronic stable angina, secondary prevention of reinfarction, paroxysmal supra-ventricular tachycardia and for rate control in atrial fibrillation/flutter. In addition to its antihypertensive and anti-ischemic actions verapamil exerts favorable effects also on glycemic control, proteinuric diabetic nephropathy, left ventricular diastolic dysfunction and sympathetic nervous system overactivity which may potentially benefit patients with DM and CRS. In this narrative review, we summarize the current evidence on the potential role of verapamil in the prevention and treatment of CRS in diabetic hypertensive patients.
糖尿病（DM）患者常伴有其他慢性合并症，包括动脉高血压（AH）、慢性肾脏病（CKD）、缺血性心脏病（IHD）以及射血分数保留的心力衰竭（HFpEF）。后几种病症的频繁关联被认为是心肾综合征（CRS）谱系的一部分，这是一组心脏和肾脏疾病，其中一个器官的急性或慢性功能障碍可能会诱发另一个器官的急性或慢性功能障碍。维拉帕米是一种非二氢吡啶类钙通道阻滞剂（CCB），广泛用于治疗高血压、慢性稳定型心绞痛、再梗死的二级预防、阵发性室上性心动过速以及房颤/房扑时的心率控制。除了其降压和抗缺血作用外，维拉帕米对血糖控制、糖尿病肾病蛋白尿、左心室舒张功能障碍和交感神经系统过度活跃也有有益作用，这可能对糖尿病和CRS患者有潜在益处。在这篇叙述性综述中，我们总结了关于维拉帕米在糖尿病高血压患者CRS预防和治疗中潜在作用的现有证据。
