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Establishing a new option for target-organ protection: rationale for ARB plus ACE inhibitor combination therapy.
Am J Hypertens. 2008 Mar; 21(3):248-56.AJ

Abstract

Activation of the renin-angiotensin system (RAS) plays an important role in the promotion of cardiovascular disease and target-organ damage, mediated in part by hypertension. Combination therapy targeting RAS activation may reduce target-organ damage and provide superior blood pressure (BP) control; combining angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) represents one possible approach. In monotherapy studies, both ACE inhibitors and ARBs have demonstrated similar positive effects on BP and on RAS-related target-organ damage, including nephropathy and congestive heart failure. Studies of combination therapy, most of which involved addition of an ARB to existing ACE inhibitor therapy, have demonstrated benefits among patients with congestive heart failure and renal disease. However, variances in study design and populations, dosing and titration methods, and clinical end points, in addition to inherent differences between agents, limit the ability to reach clinically meaningful conclusions about the value of dual RAS inhibition. Trials designed to document such efficacy are currently underway.

Authors+Show Affiliations

Rasmussen Center for Cardiovascular Disease Prevention, Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA. cohnx001@tc.umn.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

18219303

Citation

Cohn, Jay N., and Jesse M. Goldman. "Establishing a New Option for Target-organ Protection: Rationale for ARB Plus ACE Inhibitor Combination Therapy." American Journal of Hypertension, vol. 21, no. 3, 2008, pp. 248-56.
Cohn JN, Goldman JM. Establishing a new option for target-organ protection: rationale for ARB plus ACE inhibitor combination therapy. Am J Hypertens. 2008;21(3):248-56.
Cohn, J. N., & Goldman, J. M. (2008). Establishing a new option for target-organ protection: rationale for ARB plus ACE inhibitor combination therapy. American Journal of Hypertension, 21(3), 248-56. https://doi.org/10.1038/ajh.2007.56
Cohn JN, Goldman JM. Establishing a New Option for Target-organ Protection: Rationale for ARB Plus ACE Inhibitor Combination Therapy. Am J Hypertens. 2008;21(3):248-56. PubMed PMID: 18219303.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Establishing a new option for target-organ protection: rationale for ARB plus ACE inhibitor combination therapy. AU - Cohn,Jay N, AU - Goldman,Jesse M, Y1 - 2008/01/24/ PY - 2008/1/26/pubmed PY - 2008/7/2/medline PY - 2008/1/26/entrez SP - 248 EP - 56 JF - American journal of hypertension JO - Am J Hypertens VL - 21 IS - 3 N2 - Activation of the renin-angiotensin system (RAS) plays an important role in the promotion of cardiovascular disease and target-organ damage, mediated in part by hypertension. Combination therapy targeting RAS activation may reduce target-organ damage and provide superior blood pressure (BP) control; combining angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) represents one possible approach. In monotherapy studies, both ACE inhibitors and ARBs have demonstrated similar positive effects on BP and on RAS-related target-organ damage, including nephropathy and congestive heart failure. Studies of combination therapy, most of which involved addition of an ARB to existing ACE inhibitor therapy, have demonstrated benefits among patients with congestive heart failure and renal disease. However, variances in study design and populations, dosing and titration methods, and clinical end points, in addition to inherent differences between agents, limit the ability to reach clinically meaningful conclusions about the value of dual RAS inhibition. Trials designed to document such efficacy are currently underway. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/18219303/Establishing_a_new_option_for_target_organ_protection:_rationale_for_ARB_plus_ACE_inhibitor_combination_therapy_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1038/ajh.2007.56 DB - PRIME DP - Unbound Medicine ER -