Antihypertensive therapy in diabetes: The legacy effect and RAAS blockade

Massimo Volpe, Francesco Cosentino, Giuliano Tocci, Francesca Palano, Francesco Paneni

Research output: Contribution to journalArticlepeer-review


Two recently published post-monitoring follow up studies of the United Kingdom Prospective Diabetes Study (UKPDS) have shown that although early and intensive treatment of hyperglycemia provides benefits for cardiovascular mortality that extend over time, the ects of a tight antihypertensive strategy in patients with diabetes did not seem to last during the following years. The authors concluded that blood pressure control is of crucial importance in patients with diabetes but is not protective against cardiovascular events when it is not sustained. Several lines of evidence suggest, however, that early and intensive antihypertensive treatment with some classes of drugs exerts benefits that may persist during the following years. Particularly, blockade of the renin-angiotensinaldosterone system (RAAS) may interrupt the molecular and cellular mechanisms underlying cardiac and vascular remodeling and the maintenance of high blood pressure values. This review article critically discusses current evidence and explores the rationale for a legacy effect of RAAS blockade in hypertensive patients with diabetes.

Original languageEnglish
Pages (from-to)318-324
Number of pages7
JournalCurrent Hypertension Reports
Issue number4
Publication statusPublished - Aug 2011


  • High blood pressure
  • Keywords Diabetes
  • Legacy effect
  • Oxidative stress
  • Renin-angiotensin- aldosterone system
  • Vascular remodeling

ASJC Scopus subject areas

  • Internal Medicine

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