Related Experiment Video

Updated: Aug 6, 2026

Improved Rodent Model of Myocardial Ischemia and Reperfusion Injury
07:23

Improved Rodent Model of Myocardial Ischemia and Reperfusion Injury

Published on: March 7, 2022

Role of Neurohormonal Modulators in Reducing Adverse Outcomes in Patients with Ischemic Heart Disease

Arjun Talukdar1, Prasanti Sharma1, Sayak Khawas1

  • 1Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India.

Current Pharmaceutical Design
|July 22, 2026
PubMed

Insights

Neurohormonal modulators, including ACE inhibitors and ARNIs, effectively manage ischemic heart disease (IHD) by targeting the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system (SNS). These treatments improve cardiac function and survival rates in IHD patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Ischemic heart disease (IHD) progression is driven by maladaptive activation of the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system (SNS).
  • Neurohormonal modulators are crucial for mitigating adverse outcomes in IHD by targeting these overactive systems.

Purpose of the Study:

  • To critically review conventional and emerging neurohormonal modulators used in managing ischemic heart disease (IHD).
  • To evaluate the mechanisms, benefits, limitations, and future directions of these therapeutic agents.

Main Methods:

  • This narrative review synthesizes current literature on neurohormonal modulators for IHD.
  • Key drug classes discussed include ACE inhibitors, ARBs, beta-blockers, MRAs, ARNIs, and SGLT2 inhibitors.

Main Results:

  • ACE inhibitors and ARBs reduce RAAS-mediated injury; beta-blockers attenuate SNS overactivation.
  • MRAs and ARNIs target aldosterone and natriuretic peptides, respectively, to combat fibrosis and remodeling.
  • SGLT2 inhibitors offer additional benefits by improving metabolic efficiency and hemodynamic stability.

Conclusions:

  • Neurohormonal modulators significantly improve cardiac function, reduce hospitalizations, and enhance survival in IHD patients.
  • These agents have complementary mechanisms and are central to contemporary IHD management, improving quality of life.
  • Further research into their limitations and future therapeutic applications is warranted.

Keywords:
ACE inhibitorsIschemic heart diseaseNeurohormonal modulationRenin-angiotensin-aldosterone systemsympathetic nervous system

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Antianginal Drugs: Nitrates and β-Blockers01:16

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates,  such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers01:27

Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in bronchial smooth...