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Expert Rev Cardiovasc Ther. 2012 Sep;10(9):1087-92. doi: 10.1586/erc.12.100.

Update on the ROADMAP clinical trial report: olmesartan for the prevention or delay of microalbuminuria development in type 2 diabetes.

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Department of Nephrology and Hypertension, Hanover Medical School, Germany.


Albuminuria is associated with renal disease progression and cardiovascular disease development or cardiovascular complications in individuals at low, medium and high risk for these outcomes. Furthermore, in patients with vascular disease, changes in albuminuria independently predict mortality and cardiovascular and renal outcomes, and drug-induced lowering of albuminuria with the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers confers long-term cardiovascular and renal protection. However, few studies have directly examined whether these agents might also prevent the development of albuminuria and whether this translates into protection from cardiovascular disease events. The ROADMAP trial was conducted in an attempt to give answers to these questions. The results provide evidence that pharmacological blockade of angiotensin II receptors is effective in reducing the risk of new-onset albuminuria in type 2 diabetic patients. The study was not able to determine if this will also lead to a long-term reduction of cardiovascular morbidity and mortality.

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