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Benefits of the RAS blockade: clinical evidence before the ONTARGET study

Christine Perret-Guillaume1, Laure Joly, Piotr Jankowski

  • 1Department of Geriatrics, Medical School of Nancy, Nancy, France.

Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension
|June 4, 2009
PubMed

Insights

Blocking the renin-angiotensin system (RAS) reduces cardiovascular and renal disease by targeting angiotensin II (Ang II) receptor activation. RAS blockers are recommended for hypertension, heart failure, and proteinuria.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Pharmacology

Background:

  • Activation of angiotensin II (Ang II) receptors promotes vasoconstriction, cardiac and vascular hypertrophy, and fibrosis.
  • These effects contribute to cardiovascular and renal complications, including arterial stiffness, heart failure, and kidney disease.

Purpose of the Study:

  • To review the implications of renin-angiotensin blockade in cardiovascular and renal diseases.
  • To highlight the role of blocking the renin-angiotensin-aldosterone system (RAAS) in managing these conditions.

Main Methods:

  • Review of clinical studies and trials on renin-angiotensin system (RAS) blockers.
  • Analysis of the effects of RAS blockade on cardiovascular and renal fibrosis and arterial stiffness.

Main Results:

  • Renin-angiotensin blockade demonstrates direct and specific benefits in heart failure, coronary disease, stroke, and hypertensive and diabetic renal disease.
  • Beneficial cardiovascular and renal effects are linked to reduced fibrosis and arterial stiffness.

Conclusions:

  • Blocking the renin-angiotensin-aldosterone system (RAAS) offers significant cardiovascular and renal protection.
  • International guidelines recommend RAS blockers (ACE inhibitors and ARBs) as first-line treatment for hypertension, heart failure, and proteinuria.

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