Abstract
The renin angiotensin aldosterone system (RAAS) inhibitors induce an incomplete blockade of the system at different steps. Recently, the dual RAAS therapy is emerging in clinical practice, although there is a lack of evidence on safety and efficacy for this combination in several cardiovascular diseases. In this review, we evaluated the advantages and disadvantages of dual RAAS blockade in hypertension, proteinuric renal disease, heart failure and ischaemic heart disease. The role of DRIs in combination with ACEI or ARBs is promising, but still needs further studies. On the basis of the clinical outcomes and safety data the recommendations guidelines have not confirmed indications to dual RAAS blockade in essential hypertension treatment, heart failure and ischemic heart disease. Only proteinuric nephropaties and resistant hypertension may represent possible indications to dual RAAS blockade. Actually, rational combinations of either an ACEI or ARB or DRI with other classes of antihypertensives offer best solutions.
Keywords: Renin-angiotensin-aldosterone system, hypertension, heart failure, proteinuria, RAAS therapy, cardiovascular diseases, ischaemic heart disease, antihypertensives, nephropaties, aliskiren
Current Pharmaceutical Design
Title: Combinations of Renin-Angiotensin-Aldosterone System Antagonists:True Advantages?
Volume: 18 Issue: 7
Author(s): Franco Veglio, Elisabetta Puglisi, Alberto Milan and Paolo Mulatero
Affiliation:
Keywords: Renin-angiotensin-aldosterone system, hypertension, heart failure, proteinuria, RAAS therapy, cardiovascular diseases, ischaemic heart disease, antihypertensives, nephropaties, aliskiren
Abstract: The renin angiotensin aldosterone system (RAAS) inhibitors induce an incomplete blockade of the system at different steps. Recently, the dual RAAS therapy is emerging in clinical practice, although there is a lack of evidence on safety and efficacy for this combination in several cardiovascular diseases. In this review, we evaluated the advantages and disadvantages of dual RAAS blockade in hypertension, proteinuric renal disease, heart failure and ischaemic heart disease. The role of DRIs in combination with ACEI or ARBs is promising, but still needs further studies. On the basis of the clinical outcomes and safety data the recommendations guidelines have not confirmed indications to dual RAAS blockade in essential hypertension treatment, heart failure and ischemic heart disease. Only proteinuric nephropaties and resistant hypertension may represent possible indications to dual RAAS blockade. Actually, rational combinations of either an ACEI or ARB or DRI with other classes of antihypertensives offer best solutions.
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Cite this article as:
Veglio Franco, Puglisi Elisabetta, Milan Alberto and Mulatero Paolo, Combinations of Renin-Angiotensin-Aldosterone System Antagonists:True Advantages?, Current Pharmaceutical Design 2012; 18 (7) . https://dx.doi.org/10.2174/138161212799436566
DOI https://dx.doi.org/10.2174/138161212799436566 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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