Flera studier har visat nyttan av en god glykemisk kontroll vid diabetes för att förhindra mikrovaskulära komplikationer men också olika typer av hjärt/kärlsjukdomar. Idag anses behandling av hypertoni och hyperlipidemi liksom förebyggande behandling med ASA mycket viktig för denna grupp av patienter. Syftet med denna studie har varit att undersöka hur stor andel av diabetespatienterna som medicinerar med ACE-hämmare eller Angiotensin-II-receptorblockerare hos diabetiker med avseende på ålder, kön och landsting. Registerdata över samtliga receptuttag av insulin (A10A) och peroralt diabetesläkemedel (A10B) uttagna mellan 1 juli 2005 till och med 31 juni 2007 tjänade som underlag för de data som erhölls från Svenska läkemedelsförteckningen i form av Excelfiler. De filer som användes för prevalensberäkningar innehöll uppgift om ATC-kod, period, landsting, kön, antal patienter, patienter/tusen invånare, DDD/TIND, antal recept, totalkostnad och landstingskostnad.

Background: Diabetes mellitus is a chronic disease that manifests as an increased level of glucose in the blood. According to the World Health Organization (WHO), 347 million people have diabetes worldwide. In year 2004, 3.4 million people died from the consequences of high blood glucose. In the Swedish population the prevalence of diabetes is estimated to 3-4 %, out of which 85-90% are Type 2. Among senior citizens a prevalence of diabetes is seen in Sweden up to 14 - 15%.

Background:  Heart failure is a multidimensional phenomenon with high mortality. Heart failure is treated with angiotensin converting enzyme (ACE) - inhibitors or angiotensin receptor blockers (ARBs) that counteract neurohormonal stimuli that occur in heart failure, as well as providing vessel dilatation, which reduces symptoms and the need for hospitalization and increases survival. Despite this, only about 50% of heart failure patients survive 6 years after diagnosis with drug therapy, and as heart failure is increasing globally, due to improved care and treatment and increasing life expectancy of the population, there is a great need for new drugs such as LCZ696 that acts by dual inhibition of the renin - angiotensin - aldosterone system and neprilysin inhibition.Objective: The aim of this literature study was to evaluate the efficacy of current treatment and possible future treatments on mortality and morbidity in heart failure patients.Results: The examined articles show that treatment with ACE inhibitors in patients with symptomatic heart failure reduces the risk of total mortality by 16% over 3.5 years, reduces all-cause mortality or hospitalization due to heart failure with NNT (number needed to treat) = 10.4 over 3.5 years and increases median survival by 9.2 months over 12.1 years in patients with asymptomatic heart failure. Treatments with high-dose ACE inhibitors reduce mortality and hospitalization because of cardiovascular causes and hospitalizations from any cause by NNT = 30 over 3 years. Beta-blockers reduce sudden death and total mortality and cardiac death or non - fatal myocardial infarction with NNT = 38 and NNT = 23, respectively, over 12 months.

Heart failure is a condition where the heart is incapable of providing adequate blood supply to different organs in the body. The underlying causes of heart failure is some kind of disorder in the heart function, and require careful diagnostics. The basic symptoms that arise from heart failure is difficulty in breathing, that aggravate when lying down, and fatigue. The patients? symptoms and impaired quality of life can be in different stages depending on the severity of the heart failure.