title: The past, present and future of renin-angiotensin aldosterone system inhibition.
abstract: The renin-angiotensin aldosterone system (RAAS) is central to the pathogenesis of cardiovascular disease. RAAS inhibition can reduce blood pressure, prevent target organ damage in hypertension and diabetes, and improve outcomes in patients with heart failure and/or myocardial infarction. This review presents the history of RAAS inhibition including a summary of key heart failure, myocardial infarction, hypertension and atrial fibrillation trials. Recent developments in RAAS inhibition are discussed including implementation and optimization of current drug therapies. Finally, ongoing clinical trials, opportunities for future trials and issues related to the barriers and approvability of novel RAAS inhibitors are highlighted.
authors.affiliation: Duke University Medical Center, Durham, NC 27710, USA. robert.mentz@duke.edu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Mentz
authors.forename: George L
authors.initials: GL
authors.lastname: Bakris
authors.forename: Bernard
authors.initials: B
authors.lastname: Waeber
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
authors.forename: Mihai
authors.initials: M
authors.lastname: Gheorghiade
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
authors.forename: Aldo P
authors.initials: AP
authors.lastname: Maggioni
authors.forename: Karl
authors.initials: K
authors.lastname: Swedberg
authors.forename: Ileana L
authors.initials: IL
authors.lastname: Piña
authors.forename: Mona
authors.initials: M
authors.lastname: Fiuzat
authors.forename: Christopher M
authors.initials: CM
authors.lastname: O'Connor
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
authors.forename: Bertram
authors.initials: B
authors.lastname: Pitt
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000379:methods; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
keywords: Clinical trials; Heart failure; Hypertension; Myocardial infarction; Renin–angiotensin aldosterone system