Document Detail


Renin Angiotensin Aldosterone System Blockade: Little to No Rationale for ACE Inhibitor and ARB Combinations.
MedLine Citation:
PMID:  21187182     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Our understanding of the complexities and inter-related pathways of the renin-angiotensin-aldosterone system continues to evolve. Which drugs to use, when, and how, are everyday questions faced by clinicians in the ambulatory setting. Combining these classes, for the purpose of enhancing renin-angiotensin-aldosterone system blockade and incremental blood pressure, nephroprotective, and cardioprotective effects, logically has emerged as an area for scientific inquiry and clinical use. Despite the lack of evidence on safety and efficacy in most disease states, dual therapy has been embraced as a treatment option. Most studies of angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) combination therapy in the treatment of hypertension have limitations. In contrast, combination ACE inhibitor-ARB therapy in systolic heart failure has been addressed in several large randomized controlled trials. Until recently, there has been limited and conflicting evidence for the use of combination therapy for the prevention or management of nephropathy. Based on the new evidence, combination ACE inhibitor-ARB therapy in the treatment and management of hypertension, heart failure, and nephropathy should be limited.
Authors:
Amber Holdiness; Ken Monahan; Deborah Minor; Richard D de Shazo
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  124     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-28     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  15-9     Citation Subset:  AIM; IM    
Copyright Information:
2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Pharmacy, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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MeSH Terms
Descriptor/Qualifier:
Angiotensin Receptor Antagonists / administration & dosage*
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Drug Therapy, Combination
Heart Failure / drug therapy
Humans
Hypertension / drug therapy
Kidney Diseases / drug therapy
Chemical
Reg. No./Substance:
0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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