title: Modulation of the renin-angiotensin-aldosterone system in heart failure.
abstract: The renin-angiotensin-aldosterone system (RAAS) is well-established and continues to be pursued as a therapeutic target in the treatment of heart failure, predominantly due to the success of agents that block RAAS in clinical trials of systolic heart failure. The optimal treatment of heart failure patients with preserved ejection fraction (HFpEF), however, remains unclear. Early trials of direct renin inhibitors have suggested that these agents may play a role in HFpEF, but recent clinical trial results have not been encouraging. Preliminary trials of angiotensin-receptor/neprilysin inhibitors look promising. Whether results with these or other drugs will alter current recommendations remains to be seen. In this review, we assess the current understanding of the role of RAAS modulation in heart failure.
authors: Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK.
authors: J
authors: J
authors: George
authors: A D
authors: AD
authors: Struthers
authors: C C
authors: CC
authors: Lang
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002908:Chronic Disease; D019405:Cytochrome P-450 CYP11B2 / Q000037:antagonists & inhibitors*; D006333:Heart Failure / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D012084:Renin-Angiotensin System / Q000187:drug effects*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019405:Cytochrome P-450 CYP11B2