title: The renin-angiotensin-aldosterone system and heart failure.
abstract: The renin-angiotensin-aldosterone system (RAAS) plays a critical role in the pathophysiology of heart failure with reduced ejection fraction (HFrEF). Targeting components of the RAAS has produced significant improvements in morbidity and mortality. Angiotensin-converting enzyme (ACE) inhibitors remain first-line therapy for all patients with a reduced ejection fraction. Angiotensin-receptor blockers may be used instead of ACE inhibitors in patients with intolerance, or in conjunction with ACE inhibitors to further reduce symptoms. Recent data support broader indications for aldosterone antagonists in heart failure, and the combination of an ACE-inhibitor and aldosterone antagonist has become the preferred strategy for dual blockade of the RAAS.
authors.affiliation: Center for Heart Transplant and Assist Devices, Advocate Christ Medical Center, 4400 West 95th Street, Suite 407, Oak Lawn, IL 60453, USA; University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sayer
authors.forename: Geetha
authors.initials: G
authors.lastname: Bhat
mesh_terms: D000450:Aldosterone / Q000502:physiology; D000804:Angiotensin II / Q000502:physiology; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D012083:Renin / Q000502:physiology; D012084:Renin-Angiotensin System / Q000502:physiology*; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D000804:Angiotensin II; D000450:Aldosterone; D012083:Renin
keywords: Aldosterone; Angiotensin II; Angiotensin-converting enzyme inhibitors; Angiotensin-receptor blockers; Heart failure; Neurohormonal; Renin-angiotensin-aldosterone system