Angiotensin II blockade: a therapeutic strategy with wide applications.
Evidence now exists suggesting a pathologic role for angiotensin II in patients with cardiovascular disease and those with risk factors. Clinical trials such as the Losartan Intervention for Endpoint Reduction in Hypertension Study (LIFE), the Heart Outcomes Prevention Evaluation Study (HOPE), the African American Study of Kidney Disease and Hypertension (AASK), and the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study have clearly demonstrated that blood pressure reduction is important in hypertension and diabetes. If this can be accomplished with agents that block the renin-angiotensin system, then additional clinical benefit will be achieved. Clinical data on angiotensin-converting enzyme inhibitors (ACEIs) are well established, while emerging data on the use of angiotensin II receptor blockers (ARBs) continue to grow. There is evidence supporting the concept of angiotensin II escape in the presence of ACEIs. The question that remains to be answered is whether a combination of both agents (ACEIs and ARBs) can improve clinical outcomes. Ongoing clinical trials will answer this question.
Aranda
Juan M
JM
Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida 32610, USA. Arandjm@mail-cs.med.ufl.edu
Conti
C Richard
CR
D000804:Angiotensin II / Q000037:antagonists & inhibitors*; D057911:Angiotensin Receptor Antagonists; D006801:Humans; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology
D057911:Angiotensin Receptor Antagonists; D000804:Angiotensin II