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On target to dual block RAS?

Dimitris P Papadopoulos1, Vasilios Papademetriou, Thomas K Makris

  • 1Hypertension Clinic, Department of Cardiology, Laiko Hospital, Athens, Greece. jimpapdoc@yahoo.com

Angiology
|January 16, 2009
PubMed

Insights

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers offer organ protection and may reduce cardiovascular events. Combined therapy might be most effective for managing cardiovascular and metabolic conditions.

Area of Science:

  • Cardiovascular Pharmacology
  • Renal Medicine
  • Endocrinology

Background:

  • Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) are recognized for their protective effects on the heart, brain, and kidneys.
  • These drug classes can mitigate endothelial dysfunction and atherosclerosis, potentially lowering cardiovascular event risk.
  • While ACE inhibitors have demonstrated cardiovascular event reduction in coronary artery disease, data for ARBs are less extensive.

Purpose of the Study:

  • To review the cardioprotective, cerebroprotective, and nephroprotective properties of ACE inhibitors and ARBs.
  • To evaluate their role in preventing endothelial dysfunction, atherosclerosis, and cardiovascular events.
  • To explore their impact on target organ damage, cardiovascular mortality/morbidity in heart failure, atrial fibrillation, and metabolic syndrome.

Main Methods:

  • Systematic review of existing clinical data and studies on ACE inhibitors and ARBs.
  • Analysis of evidence regarding their effects on endothelial function and atherosclerosis.
  • Examination of outcomes in cardiovascular events, heart failure, atrial fibrillation, and metabolic syndrome.

Main Results:

  • ACE inhibitors and ARBs demonstrate significant cardioprotective, cerebroprotective, and nephroprotective effects.
  • Both drug classes can reverse endothelial dysfunction and atherosclerosis, contributing to reduced cardiovascular risk.
  • Evidence supports their efficacy in reducing target organ damage and improving outcomes in heart failure, with potential benefits in atrial fibrillation and metabolic syndrome.

Conclusions:

  • ACE inhibitors and ARBs are valuable agents for organ protection and cardiovascular risk reduction.
  • Combined blockade of the renin-angiotensin-aldosterone system with both agents may offer superior therapeutic benefits in certain clinical scenarios.
  • Further research is warranted to fully elucidate the long-term benefits and optimal use of ARBs in cardiovascular disease prevention.

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