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.
review · Level V
Where this comes from
- Record sourced from PubMed, PMID 25439533.
- Also identified by DOI 10.1016/j.pop.2014.08.002.
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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.
Medical subject headings
- Angiotensin-Converting Enzyme Inhibitors
- Hypertension
- Mineralocorticoid Receptor Antagonists
- Renin-Angiotensin System
- Renin Inhibitors