TY - JOUR
T1 - Role of the Renin-Angiotensin-Aldosterone System and Its Pharmacological Inhibitors in Cardiovascular Diseases
T2 - Complex and Critical Issues
AU - Borghi, Claudio
AU - Rossi, Francesco
AU - Rosei, Enrico Agabiti
AU - De Luca, Nicola
AU - Desideri, GiovanBattista B.
AU - Mancia, Giuseppe
AU - Pauletto, Paolo
AU - Parati, Gianfranco
AU - Pontremoli, Roberto
AU - Schillaci, Giuseppe
AU - Stornello, Michele
AU - Tocci, Giuliano
AU - Veglio, Franco
AU - Virdis, Agostino
AU - Volpe, Massimo
AU - Canonico, Pier Luigi
AU - Cirino, Giuseppe
AU - Cuzzocrea, Salvatore
AU - Danesi, Romano
AU - Di Luca, Monica
AU - Forti, Giorgio Cantelli
AU - Genazzani, Armando
AU - Leproux, Giovan Battista
AU - Steardo, Luca
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Hypertension is one of the major risk factor able to promote development and progression of several cardiovascular diseases, including left ventricular hypertrophy and dysfunction, myocardial infarction, stroke, and congestive heart failure. Also, it is one of the major driven of high cardiovascular risk profile in patients with metabolic complications, including obesity, metabolic syndrome and diabetes, as well as in those with renal disease. Thus, effective control of hypertension is a key factor for any preventing strategy aimed at reducing the burden of hypertension-related cardiovascular diseases in the clinical practice. Among various regulatory and contra-regulatory systems involved in the pathogenesis of cardiovascular and renal diseases, renin-angiotensin system (RAS) plays a major role. However, despite the identification of renin and the availability of various assays for measuring its plasma activity, the specific pathophysiological role of RAS has not yet fully characterized. In the last years, however, several notions on the RAS have been improved by the results of large, randomized clinical trials, performed in different clinical settings and in different populations treated with RAS inhibiting drugs, including angiotensin converting enzyme (ACE) inhibitors and antagonists of the AT1 receptor for angiotensin II (ARBs). These findings suggest that the RAS should be considered to have a central role in the pathogenesis of different cardiovascular diseases, for both therapeutic and preventive purposes, without having to measure its level of activation in each patient. The present document will discuss the most critical issues of the pathogenesis of different cardiovascular diseases with a specific focus on RAS blocking agents, including ACE inhibitors and ARBs, in the light of the most recent evidence supporting the use of these drugs in the clinical management of hypertension and hypertension-related cardiovascular diseases.
AB - Hypertension is one of the major risk factor able to promote development and progression of several cardiovascular diseases, including left ventricular hypertrophy and dysfunction, myocardial infarction, stroke, and congestive heart failure. Also, it is one of the major driven of high cardiovascular risk profile in patients with metabolic complications, including obesity, metabolic syndrome and diabetes, as well as in those with renal disease. Thus, effective control of hypertension is a key factor for any preventing strategy aimed at reducing the burden of hypertension-related cardiovascular diseases in the clinical practice. Among various regulatory and contra-regulatory systems involved in the pathogenesis of cardiovascular and renal diseases, renin-angiotensin system (RAS) plays a major role. However, despite the identification of renin and the availability of various assays for measuring its plasma activity, the specific pathophysiological role of RAS has not yet fully characterized. In the last years, however, several notions on the RAS have been improved by the results of large, randomized clinical trials, performed in different clinical settings and in different populations treated with RAS inhibiting drugs, including angiotensin converting enzyme (ACE) inhibitors and antagonists of the AT1 receptor for angiotensin II (ARBs). These findings suggest that the RAS should be considered to have a central role in the pathogenesis of different cardiovascular diseases, for both therapeutic and preventive purposes, without having to measure its level of activation in each patient. The present document will discuss the most critical issues of the pathogenesis of different cardiovascular diseases with a specific focus on RAS blocking agents, including ACE inhibitors and ARBs, in the light of the most recent evidence supporting the use of these drugs in the clinical management of hypertension and hypertension-related cardiovascular diseases.
KW - Angiotensin converting enzyme inhibitors
KW - Angiotensin receptor blockers
KW - Cardiovascular diseases
KW - Heart failure
KW - Hypertension
KW - Myocardial infarction
KW - Renal disease
KW - Renin-angiotensin system
KW - Stroke
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U2 - 10.1007/s40292-015-0120-5
DO - 10.1007/s40292-015-0120-5
M3 - Article
C2 - 26403596
AN - SCOPUS:84948990942
VL - 22
SP - 429
EP - 444
JO - High Blood Pressure and Cardiovascular Prevention
JF - High Blood Pressure and Cardiovascular Prevention
SN - 1120-9879
IS - 4
ER -