Advantages of Renin-Angiotensin System Blockade in the Treatment of Cardiovascular Diseases -

The renin angiotensin system (RAS) plays a key role in the regulation ofcardiovascular function, with angiotensin II being involved in hemodynamicand non-hemodynamic mechanism in the pathophysiologyof cardiovascular disease. A number of studies demonstrated that pharamacologicalmodulation of the RAS, either with angiotensin converting (ACE)inhibitor or an angiotensin II receptor blocker (ARB), provides cardiovascularand renal protection. Blockade of the RAS, either with ACE inhibitors orARBs, decreases cardiovascular morbidity and mortality in high risk patients.ACE inhibitors as well as ARBs are drugs of choice in congestive heart failure,as well as in diabetic nephropathy. Especially, the combined RAS blockadewith ACE inhibitors and ARBs was more effective than monotherapy in diabeticor non-diabetic nephropathy with proteinuria. However, this combinedRAS blockade was not equally dominant in treatment of hypertension andwas not recommended for widespread antihypertensive use.