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ACE inhibitors - angiotensin II receptor antagonists: A useful combination therapy for ischemic heart disease
T S Mohamed Saleem1, K Bharani1, K Gauthaman2
1Department of Pharmacology, Annamacharya College of Pharmacy, Rajampet-516126, Kadapa Dist, Andhra Pradesh, India.
Insights
Cardiovascular diseases remain a significant threat. Angiotensin II receptor antagonists and ACE inhibitors effectively reduce cardiovascular events and improve tolerability in ischemic heart disease treatment.
Area of Science:
- Cardiology
- Pharmacology
- Nephrology
Background:
- Cardiovascular diseases (CVD) and kidney diseases exhibit high morbidity and mortality, often exacerbated by renin-angiotensin system (RAS) overactivation.
- Angiotensin II (Ang II) drives progressive end-organ damage via inflammatory pathways, contributing to CVD and kidney disease progression.
Purpose of the Study:
- To review the established efficacy of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists (ARBs) in managing ischemic heart disease (IHD).
- To explore the role of monotherapy and combination therapy with ACE inhibitors and ARBs in reducing cardiovascular events and improving patient outcomes.
- To provide insights for future development of novel combination therapies and formulations.
Main Methods:
- Literature review of clinical trials and pharmacological studies on ACE inhibitors and ARBs in cardiovascular and kidney diseases.
- Analysis of the impact of RAS blockade on cardiovascular morbidity and mortality, particularly in the context of ischemic heart disease.
- Evaluation of the safety and tolerability profiles of ARBs compared to traditional therapies.
Main Results:
- ACE inhibitors and ARBs have demonstrated significant efficacy in preventing target organ damage and reducing cardiovascular morbidity and mortality in IHD.
- ARBs offer improved tolerability and safety, enhancing treatment adherence and patient outcomes.
- Clinical trials confirm that both monotherapy and combination therapy involving ACE inhibitors and ARBs effectively reduce the incidence of coronary events by targeting the RAS.
Conclusions:
- ACE inhibitors and ARBs are crucial in managing IHD by modulating the renin-angiotensin system.
- Combination therapy holds promise for further enhancing cardiovascular protection and reducing adverse events.
- Future research should focus on optimizing combination strategies and developing new drug formulations for improved patient care.
Abstract:
Morbidity and mortality from cardiovascular diseases are still high, even with the use of the best available therapies. There is mounting evidence that excessive renin-angiotensin system activation triggers much of the damaging and progressive nature of cardiovascular and kidney diseases through expression of angiotensin II. Moreover, angiotensin II play a major role in the development of end organ damage through a variety of inflammatory mechanisms. Today, angiotensins-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists have clearly demonstrated their efficacy in preventing target organ damage and in reducing cardiovascular morbidity and mortality in ischemic heart disease (IHD). Moreover, the development of angiotensin II receptor antagonists has enabled a large gain in tolerability and safety. Several clinical trials have firmly established that these drugs act on the renin-angiotensin system, reducing the incidence of coronary events with monotherapy and combination therapy. In this review we summarize the role mono- and combined therapy of ACE inhibitors and angiotensin II receptor antagonists play in ischemic heart disease. In this respect the review will improve ideas for developing new formulations with combinations of these drugs in the future.
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