title: Renin-angiotensin-aldosterone system inhibition: overview of the therapeutic use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, and direct renin inhibitors.
abstract: Angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy in hypertensive diabetic patients with macroalbuminuria, microalbuminuria, or normoalbuminuria has been repeatedly shown to improve cardiovascular mortality and reduce the decline in glomerular filtration rate. Renin-angiotensin-aldosterone system (RAAS) blockade in normotensive diabetic patients with normoalbuminuria or microalbuminuria cannot be advocated at present. Dual RAAS inhibition with ACE inhibitors plus ARBs or ACE inhibitors plus direct renin inhibitors has failed to improve cardiovascular or renal outcomes but has predisposed patients to serious adverse events.
authors.affiliation: Botsford Hospital, 28050 Grand River Avenue, Farmington Hills, MI 48336, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Mercier
authors.affiliation: Garden City Hospital, 6245 N. Inkster Road, Garden City, MI 48135, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Smith
authors.affiliation: Garden City Hospital, 6245 N. Inkster Road, Garden City, MI 48135, USA; Hypertension Nephrology Associates, PC, 18302 Middlebelt Road, Livonia, MI 48152, USA. Electronic address: jibieder@me.com.
authors.forename: Jason
authors.initials: J
authors.lastname: Biederman
mesh_terms: D000419:Albuminuria / Q000453:epidemiology; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000453:epidemiology; D012084:Renin-Angiotensin System / Q000502:physiology*; D000092502:Renin Inhibitors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D000092502:Renin Inhibitors
keywords: Albuminuria; Aldosterone; Angiotensin; Combination; Diabetes; Kidney disease; Renin; Review