Document Detail

New approaches to blockade of the renin-angiotensin-aldosterone system: mineralocorticoid-receptor blockers exert antihypertensive and renoprotective effects independently of the renin-angiotensin system.
MedLine Citation:
PMID:  20675957     Owner:  NLM     Status:  MEDLINE    
The role of angiotensin II in mediating hypertension and renal diseases is well documented, and inhibition of the renin-angiotensin-aldosterone system elicits antihypertensive and renoprotective effects. There is increasing evidence implicating aldosterone, in addition to angiotensin II, in the pathogenesis of hypertension and renal diseases. Beneficial effects of mineralocorticoid receptor (MR) blockers against these diseases have been reported and are independent of the effects exerted by renin-angiotensin system (RAS) inhibitors. MR blockers are increasingly being used, not only for primary aldosteronism but also for other resistant hypertensive patients whose blood pressure is insufficiently controlled by RAS inhibitors. In these settings, MR blockers have shown impressive results. In addition, anti-proteinuric effects of MR blockers have been observed in hypertensive patients treated with RAS inhibitors, but without significant effects on blood pressure. Interestingly, these effects of MR blockers are not always dependent on plasma aldosterone levels. These data suggest that MR blockers provide a potential therapeutic approach for patients with hypertension and renal impairment who are being treated with RAS inhibitors.
Akira Nishiyama; Koichi Hasegawa; Suwarni Diah; Hirofumi Hitomi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-07-27
Journal Detail:
Title:  Journal of pharmacological sciences     Volume:  113     ISSN:  1347-8648     ISO Abbreviation:  J. Pharmacol. Sci.     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101167001     Medline TA:  J Pharmacol Sci     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  310-4     Citation Subset:  IM    
Department of Pharmacology, Faculty of Medicine, Kagawa University, Kita-gun, Japan.
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MeSH Terms
Antihypertensive Agents / pharmacology*,  therapeutic use
Hypertension / drug therapy
Kidney / drug effects
Receptors, Mineralocorticoid / antagonists & inhibitors*
Renin-Angiotensin System / drug effects*
Reg. No./Substance:
0/Antihypertensive Agents; 0/Receptors, Mineralocorticoid

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