Renin-angiotensin system – ways of inhibition Review article
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Abstract
Renin-angiotensin (RAA) system plays an important role in regulation of both function and structure of circulatory system. Its overactivity may be involved in development of cardiovascular complications. Currently, many pharmacological agents allow reducing RAA system activity on different stages. Angiotensin-converting enzyme (ACE) inhibitors and antagonists of angiotensin II receptor (ARB) are most commonly used. Many investigations showed that both drugs were similarly effective in blood pressure reduction as well as in reduction of cardiovascular risk. Results of ONTARGET study, in which head to head comparison of ACE inhibitor and ARB has been done in high risk patients, supports above. Simultaneous use of ACE inhibitors and ARBs is justified to a lesser extent. Some studies support parallel use of both drugs in patients with heart failure or nephropathy. In ONTARGET study the combination of ACE inhibitor and ARB was associated in with more adverse events without an increase in benefit as compared with an ACE inhibitor or ARB alone.
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