Abstract
Statins effectively reduce cardiovascular disease (CVD) morbidity and mortality. However, even after low-density lipoprotein cholesterol goal attainment there is a residual CVD risk. To reduce this risk, combining statins with drugs acting on the renin-angiotensin system (RAS) was investigated. The GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE), Japanese Coronary Artery Disease (JCAD), Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) and The Assessing the Treatment Effect in Metabolic Syndrome Without Perceptible Diabetes (ATTEMPT) trials suggest that the statin plus RAS inhibition combination reduces CVD events more than a statin alone and considerably more than RAS inhibition alone. This benefit seems to be related to effects on endothelial function, vascular inflammation and the initiation, progression and rupture of atheromatous plaques. These effects are, at least in part, driven by mediators, the microRNAs (miRs), that are implicated in the pathogenesis and clinical manifestations of atherosclerosis (e.g. restoration of endothelial function and attenuation of vascular inflammation). Some miRs are favourably affected by statins and others by RAS inhibition. There is a miR family (miR-146a/b), related to coronary artery plaque destabilization that is beneficially affected by both statins and RAS inhibition.
Statins and RAS inhibition combination should be routinely prescribed in high risk patients with CVD, hypertension, obesity, metabolic syndrome, and/or diabetes to maximize clinical benefit.
Keywords: Statin, renin-angiotensin system inhibitor, combination, cardiovascular disease, low grade inflammation, endothelial function, microRNA.
Current Pharmaceutical Design
Title:Combination of Statin Plus Renin Angiotensin System Inhibition for the Prevention or the Treatment of Atherosclerotic Cardiovascular Disease
Volume: 20 Issue: 40
Author(s): Vasilios G. Athyros, Niki Katsiki, Asterios Karagiannis and Dimitri P. Mikhailidis
Affiliation:
Keywords: Statin, renin-angiotensin system inhibitor, combination, cardiovascular disease, low grade inflammation, endothelial function, microRNA.
Abstract: Statins effectively reduce cardiovascular disease (CVD) morbidity and mortality. However, even after low-density lipoprotein cholesterol goal attainment there is a residual CVD risk. To reduce this risk, combining statins with drugs acting on the renin-angiotensin system (RAS) was investigated. The GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE), Japanese Coronary Artery Disease (JCAD), Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) and The Assessing the Treatment Effect in Metabolic Syndrome Without Perceptible Diabetes (ATTEMPT) trials suggest that the statin plus RAS inhibition combination reduces CVD events more than a statin alone and considerably more than RAS inhibition alone. This benefit seems to be related to effects on endothelial function, vascular inflammation and the initiation, progression and rupture of atheromatous plaques. These effects are, at least in part, driven by mediators, the microRNAs (miRs), that are implicated in the pathogenesis and clinical manifestations of atherosclerosis (e.g. restoration of endothelial function and attenuation of vascular inflammation). Some miRs are favourably affected by statins and others by RAS inhibition. There is a miR family (miR-146a/b), related to coronary artery plaque destabilization that is beneficially affected by both statins and RAS inhibition.
Statins and RAS inhibition combination should be routinely prescribed in high risk patients with CVD, hypertension, obesity, metabolic syndrome, and/or diabetes to maximize clinical benefit.
Export Options
About this article
Cite this article as:
Athyros G. Vasilios, Katsiki Niki, Karagiannis Asterios and Mikhailidis P. Dimitri, Combination of Statin Plus Renin Angiotensin System Inhibition for the Prevention or the Treatment of Atherosclerotic Cardiovascular Disease, Current Pharmaceutical Design 2014; 20 (40) . https://dx.doi.org/10.2174/1381612820666140620115756
DOI https://dx.doi.org/10.2174/1381612820666140620115756 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Folate and Homocysteine Metabolism: Therapeutic Targets in Cardiovascular and Neurodegenerative Disorders
Current Medicinal Chemistry The Role of Nitric Oxide on Endothelial Function
Current Vascular Pharmacology The Importance of NAD in Multiple Sclerosis
Current Pharmaceutical Design Non Alcoholic Fatty Liver: Epidemiology and Natural History
Reviews on Recent Clinical Trials EGFR(s) in Aging and Carcinogenesis of the Gastrointestinal Tract
Current Protein & Peptide Science Insulin Resistance as a Therapeutic Target for Improved Endothelial Function:Metformin
Current Drug Targets - Cardiovascular & Hematological Disorders Single Nucleotide Polymorphisms (SNPs): History, Biotechnological Outlook and Practical Applications
Current Pharmacogenomics Cardioembolic Stroke: Clinical Features, Specific Cardiac Disorders and Prognosis
Current Cardiology Reviews Fatty Acid (FA) Compositions and Trans Content of Frequently Consumed Edible Oils and Fats from Iran’ Market
Current Nutrition & Food Science Oxygen Sensing, Cardiac Ischemia, HIF-1α and Some Emerging Concepts
Current Cardiology Reviews Aldose Reductase: A Multi-disease Target
Current Enzyme Inhibition Bacterial Urease and its Role in Long-Lasting Human Diseases
Current Protein & Peptide Science New Treatments for COPD in the Elderly
Current Pharmaceutical Design Efficacy and Cardiovascular Safety of Metformin
Current Drug Safety Endothelial Progenitor Cells as Potential Drug Targets
Current Drug Targets - Cardiovascular & Hematological Disorders Epidemiology and Etiology of Alzheimer’s disease: From Genetic to Non- Genetic Factors
Current Alzheimer Research Gender Bias in Acute Coronary Syndromes
Current Vascular Pharmacology Advances in the Treatment of Neurodegenerative Disorders Employing Nanoparticles
Recent Patents on Drug Delivery & Formulation Menopausal Hormone Therapy and Cardiovascular Risk: Where are we Now?
Current Vascular Pharmacology The Progress Towards the Development of DHQO Derivatives and Related Analogues with Inotropic Effects
Mini-Reviews in Medicinal Chemistry