Evidence for benefits of angiotensin receptor blockade beyond blood pressure control.
Elevated levels of angiotensin II result in oxidative stress and endothelial dysfunction, which initiate atherogenic pathologic processes that are important in cardiovascular disease development. Angiotensin II induces its deleterious effects primarily through the type 1 receptor; these effects are inhibited by angiotensin II receptor blockers (ARBs) directly at the receptor level. Angiotensin II may potentiate protective mechanisms through stimulation of the type 2 receptor, which is not blocked by ARBs. Accumulating data suggest that blockade of angiotensin II production or activity provides vascular and cardioprotective benefits, such as reduction of atrial fibrillation, acute myocardial infarction, and heart failure events. Moreover, blockade of the renin-angiotensin system has been shown to offer renal protection in subjects with and without diabetes mellitus and to reduce the risk of new-onset diabetes.
Siragy
Helmy M
HM
Department of Medicine, University of Virginia Health Center, PO Box 801409, Charlottesville, VA 22908, USA. hms7a@virginia.edu
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000517:prevention & control; D006801:Humans; D007674:Kidney Diseases / Q000517:prevention & control; D020257:Ventricular Remodeling / Q000187:drug effects; D000092502:Renin Inhibitors
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000092502:Renin Inhibitors