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

2. CVD has risen, accompanied by diabetes AHA. Circulation. 2006;113:e85-151. CDC. www.cdc.gov. National Hospital Discharge Survey CVD Discharges (millions) 90 030095 0 4 5 6 7 Year Number (millions) National Health Interview Survey Diabetes 9004989492009602 Year  119%

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

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

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.