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- W94982871 endingPage "516" @default.
- W94982871 startingPage "485" @default.
- W94982871 abstract "The results from experimental models and randomized controlled clinical trials have shown that the more intense the blockade of the renin-angiotensin system (RAS) is during angiotensin I-converting enzyme (ACE) inhibition or AT1 receptor blockade, the more effective the prevention of target organ damage is. Combined inhibition of the RAS is aimed at more complete blockade of the system through action at two different sites: ACE and AT1 receptors. This is achieved either by neutralizing the rise in renin and angiotensin (Ang) I, which follows the interruption of the Ang II-renin negative feedback loop, or by directly antagonizing Ang II, whose synthesis is in part independent of the RAS, as nonrenin-dependent pathways have been identified in cardiac and vascular tissues. By comparison with higher doses of single-site blockers , a combination of an ACE inhibitor and an AT1 receptor antagonist blocks the RAS more effectively. After demonstrating the synergistic or additive blood pressure effects of the combined RAS blockade in sodium-depleted normotensive subjects and animal models, the combined blockade of the RAS was shown to be more efficient than single-site blockade (a) in lowering BP in Caucasian hypertensive patients with predominantly low renin concentrations, with type II diabetes or with renal failure, (b) in lowering proteinuria and possibly retarding progression of renal failure in patients with diabetic and nondiabetic nephropathy, and (c) in finally improving left ventricular remodeling, cardiac function status and cardiovascular morbidity and mortality in patients with congestive heart failure. The advantage offered by combining two RAS blockers is to increase the beneficial effect of cardioprotection and nephroprotection, which are currently achieved with the highest doses of an ACE inhibitor or an AT1 receptor antagonist" @default.
- W94982871 created "2016-06-24" @default.
- W94982871 creator A5059403921 @default.
- W94982871 creator A5087581609 @default.
- W94982871 date "2004-01-01" @default.
- W94982871 modified "2023-09-27" @default.
- W94982871 title "Combined Blockade of the Renin Angiotensin System with ACE Inhibitors and AT1 Receptor Antagonists" @default.
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