Abstract
Guidelines for the treatment of hypertension allow a wide range of choices to the physicians; however some differences are present about the preferred drugs to start treatment. The most important aim remains an adequate decrease of blood pressure, something not perfectly obtained in the general population, but some classes of anti-hypertensive drugs could show protective effects on cardiovascular events, which are independent from blood pressure levels (the so called effects beyond blood pressure control). In this context antagonists of the renin-angiotensin system may represent an important help for the physicians, keeping in mind the preclinical studies showing the central role of the renin-angiotensin system not only in the regulation of blood pressure but also in the atherothrombotic processes.
The demonstration of an additional favourable effect of renin-angiotensin system blockers is not so obvious and frequently debated in the literature. Evidence-based medicine suggests that in patients at moderate/high cardiovascular risk it is difficult to have clear evidence of a specific advantage of some drug classes with respect to the others. However renin-angiotensin system blockers maintain compelling indications in particular cardiovascular situations; in addition analysis of intermediate end points, such as microalbuminuria, left ventricular hypertrophy, and arterial stiffness, gives further support to a drug-based anti-hypertension strategy. Last but not least, the optimal safety profile of these drugs, in particular of angiotensin II receptor blockers and renin inhibitors, allows their use in the very early stage of the hypertensive situation, as suggested by recent clinical trials.
Keywords: Renin-angiotensin system, ACE-inhibitors, AT1 receptor antagonists, renin inhibitors, hypertension treatment, cardiovascular prevention, blood pressure, atherothrombotic processes, microalbuminuria, angiotensin II receptor blockers
Current Pharmaceutical Design
Title: Renin-Angiotensin Antagonists: Therapeutic Effects Beyond Blood Pressure Control?
Volume: 18 Issue: 7
Author(s): Franco Dallegri
Affiliation:
Keywords: Renin-angiotensin system, ACE-inhibitors, AT1 receptor antagonists, renin inhibitors, hypertension treatment, cardiovascular prevention, blood pressure, atherothrombotic processes, microalbuminuria, angiotensin II receptor blockers
Abstract: Guidelines for the treatment of hypertension allow a wide range of choices to the physicians; however some differences are present about the preferred drugs to start treatment. The most important aim remains an adequate decrease of blood pressure, something not perfectly obtained in the general population, but some classes of anti-hypertensive drugs could show protective effects on cardiovascular events, which are independent from blood pressure levels (the so called effects beyond blood pressure control). In this context antagonists of the renin-angiotensin system may represent an important help for the physicians, keeping in mind the preclinical studies showing the central role of the renin-angiotensin system not only in the regulation of blood pressure but also in the atherothrombotic processes.
The demonstration of an additional favourable effect of renin-angiotensin system blockers is not so obvious and frequently debated in the literature. Evidence-based medicine suggests that in patients at moderate/high cardiovascular risk it is difficult to have clear evidence of a specific advantage of some drug classes with respect to the others. However renin-angiotensin system blockers maintain compelling indications in particular cardiovascular situations; in addition analysis of intermediate end points, such as microalbuminuria, left ventricular hypertrophy, and arterial stiffness, gives further support to a drug-based anti-hypertension strategy. Last but not least, the optimal safety profile of these drugs, in particular of angiotensin II receptor blockers and renin inhibitors, allows their use in the very early stage of the hypertensive situation, as suggested by recent clinical trials.
Export Options
About this article
Cite this article as:
Dallegri Franco, Renin-Angiotensin Antagonists: Therapeutic Effects Beyond Blood Pressure Control?, Current Pharmaceutical Design 2012; 18 (7) . https://dx.doi.org/10.2174/138161212799436575
DOI https://dx.doi.org/10.2174/138161212799436575 |
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
-
Effects of Alcohol in the Lung
Current Respiratory Medicine Reviews Marine Collagen as a Source of Bioactive Molecules: A Review
The Natural Products Journal Chronic Hyperuricemia, Uric Acid Deposit and Cardiovascular Risk
Current Pharmaceutical Design An Umbrella Review of Nuts Intake and Risk of Cardiovascular Disease
Current Pharmaceutical Design Conference Report (11th International Conference on Neuroprotective Agents, Wendake, Quebec City, Quebec, Canada, Sept 30-Oct 3, 2012)
CNS & Neurological Disorders - Drug Targets Syndrome of Supine Hypertension with Orthostatic Hypotension: Pathophysiology and Clinical Approach
Current Cardiology Reviews Role of Angiogenesis Inhibitors in Colorectal Cancer: Sensitive and Insensitive Tumors
Current Cancer Drug Targets Serum Uric Acid is Independently Associated with Diastolic Dysfunction in Apparently Healthy Subjects with Essential Hypertension
Current Vascular Pharmacology Pharmacology of Ivabradine and the Effect on Chronic Heart Failure
Current Topics in Medicinal Chemistry Uveitis in Horses, Rats and Man: What Do We Learn from Our Pets?
Current Immunology Reviews (Discontinued) Averrhoa bilimbi L. leaf Aqueous Extract Modulates both Cardiac Contractility and Frequency in the Guinea-pig Atrium by the Activation of Muscarinic Receptors
Letters in Drug Design & Discovery The Effect of Antihypertensive Drugs on Carotid Intima Media Thickness: An Up-to-Date Review
Current Medicinal Chemistry Renoprotective Effects of SGLT2 Inhibitors: Beyond Glucose Reabsorption Inhibition
Current Vascular Pharmacology Association Between the Levels of Circulating Adhesion Molecules and Biopterins in Type-2 Diabetic Normotensive Patients Adhesion Molecules and Biopterins
Endocrine, Metabolic & Immune Disorders - Drug Targets In Search for the Troponin of the Kidney
Current Medicinal Chemistry Biochemical Screening for in utero Drug Exposure
Drug Metabolism Letters Antiplatelet and Anticoagulation Strategies in the Prevention and Treatment of Ischemic Stroke
Current Pharmaceutical Design Latest Results for Anti-Angiogenic Drugs in Cancer Treatment
Current Pharmaceutical Design Pharmacogenomics of Essential Hypertension: Are We Going the Right Way?
Cardiovascular & Hematological Agents in Medicinal Chemistry Pulmonary Hypertension: Types and Treatments
Current Cardiology Reviews