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Advancing Our Understanding of RAAS Modulation in High-Risk Patients

Advancing Our Understanding of RAAS Modulation in High-Risk Patients. CVD has risen , accompanied by diabetes. CVD. Diabetes. 7.  119%. 6. Discharges (millions). Number (millions). 5. 4. 0. 90. 90. 92. 94. 96. 98. 00. 02. 04. 95. 00. 03. Year. Year. National Hospital

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Advancing Our Understanding of RAAS Modulation in High-Risk Patients

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  1. Advancing Our Understanding of RAAS Modulation in High-Risk Patients

  2. CVD has risen, accompanied by diabetes CVD Diabetes 7 119% 6 Discharges (millions) Number (millions) 5 4 0 90 90 92 94 96 98 00 02 04 95 00 03 Year Year National Hospital Discharge Survey National HealthInterview Survey AHA. Circulation. 2006;113:e85-151. CDC. www.cdc.gov.

  3. Continued increase in CVD and diabetes is predicted in US By 2050, diabetes will account for an estimated 31.4 million deaths from CVD 136% Incidence of diabetes, all ages (millions) Year Narayan KMV et al. Diabetes Care. 2006;29:2114-6.NIDDK. http://diabetes.niddk.nih.gov.

  4. Discharge ACEI post-MI remains suboptimal Q1 2006 CRUSADE data, n = 6945 Discharge medication use(%) † *LVEF <40%, CHF, DM, HTN†Known hyperlipidemia, TC, LDL-C CRUSADE. www.crusadeqi.com.

  5. AHA/ACC secondary-prevention guidelines: ACEIs and ARBs ACEIs • All patients with LVEF ≤40%, hypertension, diabetes, or chronic kidney disease (IA) • Consider for all other patients (IB) • Optional: Lower-risk, post-revascularization patients with normal LVEF and well-controlled risk factors (IIaB) ARBs • ACEI-intolerant patients with HF or post-MI LVEF ≤40% (IA) • Consider in other ACEI-intolerant patients (IB) • Consider use in combination with ACEIs in systolic dysfunction HF (IIbB) Smith SC et al. Circulation. 2006;113:2363-72.

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