| Renin Angiotensin Aldosterone System Blockade: Little to No Rationale for ACE Inhibitor and ARB Combinations. | |
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MedLine Citation:
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PMID: 21187182 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Amber Holdiness; Ken Monahan; Deborah Minor; Richard D de Shazo |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The American journal of medicine Volume: 124 ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-28 Completed Date: 2011-01-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 15-9 Citation Subset: AIM; IM |
Copyright Information:
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2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Pharmacy, University of Mississippi Medical Center, Jackson, MS 39216, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin Receptor Antagonists
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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:
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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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