Los pacientes que tienen diabetes mellitus tienen un riesgo aumentado de desarrollar insuficiencia cardiaca. Por otra parte, los pacientes con insuficiencia cardiaca que son diabéticos tienen peor pronóstico, con mayor mortalidad y mayors tasas de ingresos que los no diabéticos. Por tanto, prevenir la aparición de la diabetes mellitus puede ser un aspecto de una gran relevancia clínica en los sujetos con afección cardiaca en general, y especialmente en aquéllos con insuficiencia cardiaca. No todos los fármacos cardiovasculares han demostrado los mismos efectos en el desarrollo futuro de la diabetes mellitus. Principalmente los inhibidores de la enzima de conversión de la angiotensina (IECA) y los antangonistas de los receptores de la angiotensina (ARA-II) han mostrado un efecto beneficioso respecto de los diuréticos y los bloqueadores beta en la aparición de nuevos casos de diabetes mellitus en los sujetos hipertensos. En pacientes con insuficiencia cardiaca, el estudio CHARM ha demostrado que un ARA-II (candesartán) puede reducir el riesgo de aparición de nuevos casos de diabetes. Este hallazgo puede ser de gran interés clínico para el manejo de estos pacientes y, hasta la fecha, supone la única evidencia disponible de la capacidad de un ARA-II de reducir la tasa de aparición de diabetes en la insuficiencia cardiaca.
Palabras clave
Insuficiencia cardiaca
Diabetes mellitus
Antagonistas de los receptores de la angiotensina II
Candesartán
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