System The Cardiovascular Continuum Myocardial Infarction Heart Failure EndStage Heart Disease Plaque Rupture Risk Factors Hypertension Hyperlipidemia Diabetes Atherosclerosis Endothelial Dysfunction ID: 918903
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Slide1
1
The
Renin
Angiotensin
System
Slide2The Cardiovascular Continuum
Myocardial Infarction
Heart Failure
End-Stage Heart Disease
Plaque Rupture
Risk Factors
Hypertension
Hyperlipidemia
Diabetes
Atherosclerosis
Endothelial Dysfunction
Coronary Artery
Disease
Dilatation/Remodeling
Angiotensin
II
Slide3E. Petrillo 100 Years of the Renin-Angiotensin System, 1998
Slide4The
renin–angiotensin
systemEasthope SE, Jarvis B. Drugs 2002; 62:1253–1287.AngiotensinogenAT1VasoconstrictionRenal sodium reabsorption Cell growth and proliferation(remodelling)ReninChymaseTrypsinPeptidaseACE inhibitorsAngiotensin IAngiotensin IIAT2Vasodilation
ApoptosisDifferentiationAntiproliferationANGIOTENSIN RECEPTORBLOCKERSACE
Slide5Schmieder et al Lancet 369: 1208–1219,2007
2007 - Expanding View of the
Complexity of the “RAS
”
Slide6Benefits of ARBs over ACE inhibitors
ARBs provide a more specific and selective blockade of the effects of
angiotensin
II than ACE inhibitors ARBs tend to have more favourable tolerability than ACE inhibitorsUnlike ACE inhibitors, ARBs do not disrupt bradykinin and tachykinin degradation, leading to a much lower incidence of treatment-related coughMcClellan KJ, Goa KL. Drugs 1998; 56: 847–869.
Slide7RAAS Blockade and Cardio-Renal Protection in Clinical Outcome Trials