Have the renin-angiotensin-aldosterone system perturbations in cardiovascular disease been exhausted?
The renin-angiotensin-aldosterone system (RAAS) plays an important role in blood pressure control and volume homeostasis. Inappropriate activation of the RAAS has been implicated in the pathogenesis of hypertension and related cardiovascular disease. Several classes of agents that block RAAS signaling have been shown to be effective antihypertensives and to have cardioprotective and renoprotective properties. Because blockade of the RAAS is incomplete with any of the currently available monotherapies, combinations of these agents have been tested and shown to provide additional clinical benefit in patients with hypertension and various forms of cardiovascular and renal disease.
Mansur
Sulaf J
SJ
Jefferson Clinic PC, Birmingham, AL, USA.
Hage
Fadi G
FG
Oparil
Suzanne
S
D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D000451:Mineralocorticoid Receptor Antagonists; D012083:Renin / Q000187:drug effects / Q000502:physiology; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology; D000092502:Renin Inhibitors
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D000451:Mineralocorticoid Receptor Antagonists; D012083:Renin; D000092502:Renin Inhibitors
Am J Med. 2009 Mar;122(3):290-300
19272490
N Engl J Med. 2003 Apr 3;348(14):1309-21
12668699
Can J Cardiol. 2010 May;26(5):236-40
20485687
N Engl J Med. 2003 Nov 13;349(20):1893-906
14610160
Am J Hypertens. 2003 Nov;16(11 Pt 1):925-30
14573330
J Am Soc Nephrol. 2006 Dec;17(12 Suppl 3):S250-4
17130270
Hypertension. 2007 Apr;49(4):839-45
17309946
J Int Med Res. 2005;33 Suppl 1:39A-49A
16222899
Am J Hypertens. 2007 Jan;20(1):11-20
17198906
Curr Probl Cardiol. 2009 Feb;34(2):51-84
19135616
Lancet. 2008 Sep 27;372(9644):1174-83
18757085
J Pharmacol Exp Ther. 1992 Mar;260(3):1410-5
1545401
J Am Coll Cardiol. 2009 Apr 14;53(15):e1-e90
19358937
JAMA. 1996 May 15;275(19):1507-13
8622227
J Renin Angiotensin Aldosterone Syst. 2007 Dec;8(4):190-8
18205098
J Clin Invest. 2002 Jun;109(11):1417-27
12045255
Lancet. 2007 Jul 21;370(9583):221-229
17658393
Circulation. 2008 Jun 24;117(25):e510-26
18574054
Circulation. 1999 Sep 7;100(10):1056-64
10477530
Circulation. 2000 Apr 4;101(13):1586-93
10747353
Hypertension. 2010 Jan;55(1):147-52
19858405
Ther Clin Risk Manag. 2009 Jun;5(3):459-64
19707255
N Engl J Med. 1999 Sep 2;341(10):709-17
10471456
Am J Hypertens. 2009 Oct;22(10):1032-40
19661925
Cleve Clin J Med. 2009 Sep;76(9):533-42
19726558
Am J Kidney Dis. 2004 May;43(5 Suppl 1):S1-290
15114537
Lancet. 2008 Aug 16;372(9638):547-53
18707986
Diabetes Care. 2005 Feb;28(2):273-7
15677778
J Hypertens. 1992 Aug;10(8):803-12
1325513
Nat Clin Pract Nephrol. 2007 Sep;3(9):486-92
17717561
Ann Intern Med. 2008 Jan 1;148(1):30-48
17984482
Circulation. 2002 Jul 9;106(2):246-53
12105166
Lancet. 2003 Sep 6;362(9386):767-71
13678869
Circ Heart Fail. 2008 May;1(1):17-24
19808266
Circulation. 2005 Jun 28;111(25):3411-9
15967846
J Cardiovasc Pharmacol. 1990 Feb;15(2):276-82
1689424
Hypertension. 2005 May;45(5):880-6
15809363
Hypertension. 2008 Jul;52(1):130-6
18490518
Nephrol Dial Transplant. 2009 May;24(5):1663-71
19145003
N Engl J Med. 2001 Dec 6;345(23):1667-75
11759645
Hypertens Res. 2010 Jan;33(1):11-21
19911001
Hypertension. 2002 Jan;39(1):E1-8
11799102
J Hypertens. 2009 Nov;27(11):2121-58
19838131
Curr Med Res Opin. 2008 Apr;24(4):1039-47
18307835
N Engl J Med. 2008 Jun 5;358(23):2433-46
18525041
Clin J Am Soc Nephrol. 2009 Feb;4(2):361-8
19118120
J Am Soc Nephrol. 2004 Dec;15(12):3126-33
15579516
Circulation. 2009 Feb 3;119(4):530-7
19153265
Diabetes Care. 2009 Oct;32(10):1873-9
19587362
N Engl J Med. 2000 Jan 20;342(3):145-53
10639539
N Engl J Med. 2008 Apr 10;358(15):1547-59
18378520
Cardiol Clin. 2008 Nov;26(4):527-35
18929229
Hypertension. 2002 Aug;40(2):117-23
12154100
BMJ. 2000 Dec 9;321(7274):1440-4
11110735
Clin J Am Soc Nephrol. 2009 Mar;4(3):542-51
19261819
Rev Cardiovasc Med. 2006 Spring;7(2):45-54
16915123
Kidney Int. 2007 Oct;72(7):879-85
17667984
FASEB J. 2006 Jul;20(9):1546-8
16720735