{"title":"Treatment of Essential Hypertension with Emphasis in the Renin-Angiotensin System: How to Prevent Secondary Outcomes without Adding Fuel to the Fire","authors":"G. L. Salvador","doi":"10.5772/INTECHOPEN.86853","DOIUrl":null,"url":null,"abstract":"The effectiveness of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blocker AT-1 (ARBs) in reducing the systemic hypertension (SH) is widely known. However their comparative outcomes resulting from prolonged use remain unknown. The objective of this chapter is to discuss the evidence of prospective randomized double-blind clinical trials; all the events result from prolonged use of ACEIs or ARBs in hypertensive patients. In lowering blood pressure, the use of ACE inhibitors or ARBs reduces, in long-term use, the risk of acute myocardial infarction, stroke, and heart failure. However, the use of ACEIs is effective in an overall quantitative analysis; the total mortality regarding cardiovascular causes an outcome that was not observed with the use of ARBs. This fact is assumed to be related to the higher plasma concentration of bradykinin in the use of ACEIs, a well-known cardiovascular-protective factor.","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"31 1","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2019-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Renin-Angiotensin-Aldosterone System","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5772/INTECHOPEN.86853","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
The effectiveness of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blocker AT-1 (ARBs) in reducing the systemic hypertension (SH) is widely known. However their comparative outcomes resulting from prolonged use remain unknown. The objective of this chapter is to discuss the evidence of prospective randomized double-blind clinical trials; all the events result from prolonged use of ACEIs or ARBs in hypertensive patients. In lowering blood pressure, the use of ACE inhibitors or ARBs reduces, in long-term use, the risk of acute myocardial infarction, stroke, and heart failure. However, the use of ACEIs is effective in an overall quantitative analysis; the total mortality regarding cardiovascular causes an outcome that was not observed with the use of ARBs. This fact is assumed to be related to the higher plasma concentration of bradykinin in the use of ACEIs, a well-known cardiovascular-protective factor.
期刊介绍:
JRAAS is a peer-reviewed, open access journal, serving as a resource for biomedical professionals, primarily with an active interest in the renin-angiotensin-aldosterone system in humans and other mammals. It publishes original research and reviews on the normal and abnormal function of this system and its pharmacology and therapeutics, mostly in a cardiovascular context but including research in all areas where this system is present, including the brain, lungs and gastro-intestinal tract.