Research has proven that blood pressure is an important modifiable risk factor for diabetic retinopathy and that lowering high blood pressure significantly reduces the development and progression of retinopathy in both type 1 and type 2 diabetic patients. The renin-angiotensin-system (RAS) has been shown to become activated in diabetes. Hyperglycemia stimulates the angiotensin AT1-receptor and downstream chains of events resulting in diabetic end organ damage. Pharmacological RAS inhibition may thus be a beneficial therapeutic strategy in the management of diabetic retinopathy. The present review article details therapeutic RAS inhibition in diabetic retinopathy with an emphasis on recently published evidence. Future research on the potential effects of RAS blockade will be important while using these drugs as adjuncts in the treatment of diabetic retinopathy.
Keywords: Blood pressure, diabetes mellitus, renin-angiotensin-system, diabetic retinopathy, DIRECT, NAVIGATOR, DREAM, EUCLID
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