Final answer:
Patients with diffuse atherosclerosis on ACEi or ARBs should have their renal function and potassium levels monitored closely due to the risk of kidney function decline and metabolic acidosis, which can cause hyperkalemia and worsen pre-existing cardiovascular conditions.
Step-by-step explanation:
In patients with diffuse atherosclerosis, after starting treatment with ACE inhibitors (ACEi) or Angiotensin Receptor Blockers (ARBs), it is important to monitor renal function closely due to the risk of adverse drug effects. These medications can potentially cause a decline in renal function, especially in patients with pre-existing kidney disease, which may lead to metabolic acidosis, a condition characterized by the accumulation of sulfates, phosphates, uric acid, and other metabolic byproducts. This condition can also lead to increased excitability of cardiac and neuronal membranes, contributing to hyperkalemia.
Moreover, in the specific context of patients with chronic kidney disease (CKD) and accelerated atherosclerosis, there is an increased likelihood of developing cardiovascular diseases such as Coronary Artery Disease (CAD). These patients tend to have a worse prognosis, thus careful monitoring is essential to manage these risks appropriately.
Additionally, after the approval and widespread use of any new medication like ACEi/ARBs, continuous evaluation through a robust pharmacovigilance system is required to ensure long-term safety and evaluate the drug's effects in various patient subgroups. This involves routine check-ups and tests to monitor the patient's response and adjust treatment as necessary.