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

Abstract

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.

Keywords::

• albuminuria
• angiotensin-converting enzyme blockers
• angiotensin II type 1 receptor blockers
• cardiovascular risk
• diabetic nephropathy
• hypertension
• microalbuminuria
• renin–angiotensin system

Financial & competing interests disclosure

J Menne has received honoraria from Daiichi-Sankyo, Novartis and Berlin Chemie. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.