Posted on 01/15/2020 5:35:25 PM PST by ConservativeMind
The reninangiotensinaldosterone system plays an important role in the pathophysiology of hypertension and is closely related with cardio- and cerebrovascular events and chronic kidney diseases. Each angiotensin receptor blocker (ARB) is important in the treatment of hypertension, according to the results of recent years. This is a practical review of the available evidence on the different benefits of ARBs beyond their blood pressure-lowering effect, with an emphasis on the differences found between the particular compounds and the therapeutic implications of the findings, with specific reference to the co-morbidities.
Introduction
The appearance of angiotensin receptor blockers (ARBs) amongst the therapeutic options in the treatment of cardiovascular diseases (CVDs) was a new milestone in the history of hypertension treatment. It further widened the range of possibilities for personalized therapy, especially for patients who cannot tolerate the use of angiotensin converting enzyme inhibitors (ACEIs). ARBs have shown excellent efficacy, they have no negative metabolic effects and they cause no accumulation of bradykinin. They also have an ability to activate the angiotensin II type 2 (AT2) receptors, which causes vasodilatation in the small vessels and presumably leads to additional cardiac and renal protection.
There is a vast amount of literature on antihypertensive and cardiovascular (CV) therapeutic choices, and recommendations are available as to when a renin-angiotensin-aldosterone system (RAAS) inhibitor should be the first drug of choice. According to the latest international guidelines, ACEIs or ARBs should be preferred in patients with co-morbid microalbuminuria, renal dysfunction and chronic kidney disease (CKD), metabolic syndrome and diabetes mellitus (DM), atherosclerosis, chronic stable angina and previous myocardial infarction (MI), atrial fibrillation (AF) as well as heart failure (HF) [13].
...Nevertheless, several studies are available where certain ARBs have shown additional beneficial effect; the present review of the available evidence should provide help in treatment selection for individual patients.
(Excerpt) Read more at ncbi.nlm.nih.gov ...
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Good information.
Thank you for posting this.
Big thank you for posting this.
Something to discuss with my cardiologist on my next visit.
Of course, you need to inform your doctor of these issues if they didnt already know.
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