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Angiotensin II blockade: a therapeutic strategy with wide applications

Juan M Aranda1, C Richard Conti

  • 1Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida 32610, USA. Arandjm@mail-cs.med.ufl.edu

Clinical Cardiology
|December 3, 2003
PubMed

Insights

Blocking the renin-angiotensin system is key for managing hypertension and diabetes. Combining angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) may offer further clinical benefits in cardiovascular disease.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Endocrinology

Background:

  • Angiotensin II plays a pathologic role in cardiovascular disease and associated risk factors.
  • Clinical trials demonstrate the importance of blood pressure reduction in hypertension and diabetes.

Purpose of the Study:

  • To evaluate the clinical benefits of blocking the renin-angiotensin system.
  • To explore the potential advantages of combining angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs).

Main Methods:

  • Review of clinical trial data, including LIFE, HOPE, AASK, and RENAAL studies.
  • Analysis of established data on ACEIs and emerging data on ARBs.

Main Results:

  • Blood pressure reduction is crucial for managing hypertension and diabetes.
  • ACEIs have well-established clinical data; ARB data are growing.
  • Evidence suggests "angiotensin II escape" can occur with ACEIs.

Conclusions:

  • Agents blocking the renin-angiotensin system offer additional clinical benefits.
  • The combination of ACEIs and ARBs requires further investigation to determine its impact on clinical outcomes.
  • Ongoing clinical trials are designed to answer the question of combined ACEI and ARB efficacy.

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