Cardiovascular Drugs and Therapy

, Volume 27, Issue 2, pp 171–179 | Cite as

RAAS Inhibitors and Cardiovascular Protection in Large Scale Trials

Review Article


Hypertension, coronary artery disease and heart failure affect over half of the adult population in most Western societies, and are prime causes of CV morbidity and mortality. With the ever-increasing worldwide prevalence of CV disease due to ageing and the “diabetes” pandemic, guideline groups have recognized the importance of achieving cardioprotection in affected individuals as well as in those at risk for future CV events. The renin-angiotensin-aldosterone system (RAAS) is the most important system controlling blood pressure (BP), cardiovascular and renal function in man. As our understanding of the crucial role of RAAS in the pathogenesis of most, if not all, CV disease has expanded over the past decades, so has the development of drugs targeting its individual components. Angiotensin-converting enzyme inhibitors (ACEi), Ang-II receptor blockers (ARB), and mineralcorticoid receptor antagonists (MRA) have been evaluated in large clinical trials for their potential to mediate cardioprotection, singly or in combination. Direct renin inhibitors are currently under scrutiny, as well as novel dual-acting RAAS-blocking agents. Herein, we review the evidence generated from large-scale clinical trials of cardioprotection achieved through RAAS-blockade.


RAAS ACE-inhibitor ARB Cardioprotection Hypertension Heart failure 


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© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Department of Epidemiology and Preventive MedicineMonash Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Alfred HospitalMelbourneAustralia
  2. 2.Department of Cardiology BOslo University Hospital UllevålOsloNorway

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