The past, present and future of renin-angiotensin aldosterone system inhibition

被引:92
|
作者
Mentz, Robert J. [1 ]
Bakris, George L. [2 ]
Waeber, Bernard [3 ,4 ]
McMurray, John J. V. [5 ]
Gheorghiade, Mihai [6 ]
Ruilope, Luis M. [7 ]
Maggioni, Aldo P. [8 ]
Swedberg, Karl [9 ]
Pina, Ileana L. [10 ]
Fiuzat, Mona [1 ]
O'Connor, Christopher M. [1 ]
Zannad, Faiez [11 ]
Pitt, Bertram [12 ]
机构
[1] Duke Univ, Med Ctr, Durham, NC 27710 USA
[2] Univ Chicago Med, Chicago, IL USA
[3] CHU Vaudois, Lausanne, Switzerland
[4] Univ Lausanne, Lausanne, Switzerland
[5] Univ Glasgow, BHF Glasgow Cardiovasc Res Ctr, Glasgow, Lanark, Scotland
[6] Northwestern Univ, Feinberg Sch Med, Ctr Cardiovasc Innovat, Chicago, IL 60611 USA
[7] Hosp 12 Octubre, E-28041 Madrid, Spain
[8] Assoc Nazl Med Cardiol Osped Res Ctr, Florence, Italy
[9] Univ Gothenburg, Gothenburg, Sweden
[10] Montefiore Einstein Med Ctr, New York, NY USA
[11] Ctr Invest Clin, Nancy, France
[12] Univ Michigan, Sch Med, Univ Hosp, Ann Arbor, MI USA
关键词
Renin-angiotensin aldosterone system; Hypertension; Heart failure; Myocardial infarction; Clinical trials; CONVERTING-ENZYME-INHIBITORS; CHRONIC HEART-FAILURE; LEFT-VENTRICULAR DYSFUNCTION; ACUTE MYOCARDIAL-INFARCTION; MINERALOCORTICOID RECEPTOR ACTIVATION; HIGH-RISK PATIENTS; ATRIAL-FIBRILLATION; DOUBLE-BLIND; RANDOMIZED-TRIAL; II-RECEPTOR;
D O I
10.1016/j.ijcard.2012.10.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The renin-angiotensin aldosterone system (RAAS) is central to the pathogenesis of cardiovascular disease. RAAS inhibition can reduce blood pressure, prevent target organ damage in hypertension and diabetes, and improve outcomes in patients with heart failure and/or myocardial infarction. This review presents the history of RAAS inhibition including a summary of key heart failure, myocardial infarction, hypertension and atrial fibrillation trials. Recent developments in RAAS inhibition are discussed including implementation and optimization of current drug therapies. Finally, ongoing clinical trials, opportunities for future trials and issues related to the barriers and approvability of novel RAAS inhibitors are highlighted. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:1677 / 1687
页数:11
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