Efficacy of Angiotensin Receptor Blockers in Cardiovascular Disease |
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Authors: | Aldo P Maggioni |
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Institution: | (1) ANMCO Research Center, Italian Association of Hospital Cardiologists, Via La Marmora 34, 50121 Florence, Italy |
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Abstract: | The cardiovascular continuum describes the progression of pathophysiologic events from cardiovascular risk factors to symptomatic
cardiovascular disease (CVD) and life-threatening events. Pharmacologic intervention early in the continuum may prevent or
slow CVD development and improve quality of life. The renin–angiotensin–aldosterone system (RAAS) is central to the pathophysiology
of CVD at many stages of the continuum. Numerous clinical trials of angiotensin converting enzyme (ACE) inhibitors and angiotensin
receptor blockers (ARBs) have shown that RAAS blockade provides benefits to patients across the continuum. ARBs are as effective
as ACE inhibitors in the treatment of hypertension; however tolerability and adherence to therapy appear to be improved with
ARBs. Large clinical trials have shown that ARBs may provide therapeutic benefits beyond blood pressure control in patients
with diabetes, heart failure or at risk of heart failure following a myocardial infarction. In addition, ARBs have been shown
to provide protective effects in patients with impaired renal function or left ventricular hypertrophy. Additional clinical
trials are ongoing to further characterize the role of ARBs in CVD management. |
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Keywords: | renin– angiotensin– aldosterone system angiotensin receptor blockers ACE inhibitors hypertension new-onset diabetes diabetic nephropathy atrial fibrillation myocardial infarction heart failure |
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