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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Mega clinical trials which have shaped the RAS intervention clinical practice
1Hypertoniezentrum Bonn, Am Burgweiher 52-54, 53123 Bonn, Germany dusing@outlook.com.
Therapeutic Advances in Cardiovascular Disease
|June 9, 2016
Summary
Angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) effectively treat hypertension and offer cardioprotective and renal benefits. ARBs are better tolerated than ACE-Is, and combining them is not recommended.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Drugs targeting the renin-angiotensin system are crucial for managing cardiovascular and renal diseases.
- Extensive clinical research supports their use in heart failure, myocardial infarction, hypertension, and chronic kidney disease.
Purpose of the Study:
- To review evidence from mega and pivotal trials on angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs).
- To provide perspective on the accumulated evidence regarding the efficacy and safety of ACE-Is and ARBs.
Main Methods:
- Comprehensive review of mega trials (>1000 patients) and pivotal trials.
- Analysis of data from 25 mega trials of ACE-Is and 27 mega trials of ARBs.
Main Results:
- ACE-Is and ARBs are effective for hypertension, comparable to conventional therapies, with added cardioprotective and renal benefits.
- Both drug classes demonstrate efficacy in reducing cardiovascular events and protecting renal function.
- ARBs show better tolerability compared to ACE-Is, with similar effects on morbidity and mortality endpoints.
Conclusions:
- ACE-Is and ARBs offer significant benefits for cardiovascular patients, though blood-pressure-independent protection remains debated.
- Combined use of ACE-Is and ARBs should be avoided; full doses of either agent are recommended for greater prognostic benefit.
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