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Role of Angiotensin-Receptor Blockers in the Prevention of Cardiovascular Risk: Clinical Guidelines

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Book cover Current News in Cardiology

Abstract

The development and progression of cardiovascular disease can be regarded as a continuum (Fig. 1) [1]. Targeting different points within this continuum is therefore of major importance for reducing cardiovascular morbidity and mortality. Inhibition of the renin-angiotensin-aldosterone system (RAAS) has become a key target in this regard, given that angiotensin II (Ang II) has been implicated as a pathogenic factor at many steps in the development and progression of cardiovascular disease [2, 3].

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References

  1. Dzau V, Braunwald E (1991) Resolved and unresolved issues in the prevention and treatment of coronary artery disease: a workshop consensus statement. Am Heart J 121:1244–1263

    Article  PubMed  CAS  Google Scholar 

  2. Weber MA (2003) Angiotensin receptor blockers and the cardiovascular continuum: what future is indicated by recent successes? Eur Heart J Supplements 5(Suppl C):C1–C4

    Article  Google Scholar 

  3. Burnier M, Brunner HR (2000) Angiotensin II receptor antagonists. Lancet 355:637–645

    Article  PubMed  CAS  Google Scholar 

  4. Julius S, Kjeldsen SE, Weber M et al (2004) Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 363:2022–2031

    Article  PubMed  CAS  Google Scholar 

  5. Dahlöf B, Devereux RB, Kjeldsen SE et al (2002) Cardiovascular morbidity and mortality in the Losartan Intervention For End point reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 359:995–1003

    Article  PubMed  Google Scholar 

  6. Thurmann PA, Kenedi P, Schmidt A et al (1998) Influence of the angiotensin II antagonist valsartan on left ventricular hypertrophy in patients with essential hypertension. Circulation 98:2037–2042

    PubMed  CAS  Google Scholar 

  7. Malmquist K, Kahan T, Edner M et al (2001) Regression of left ventricular hypertrophy in human hypertension with irbesartan. J Hypertens 19:1167–1176

    Article  Google Scholar 

  8. Devereux RB, Dahlöf B, Kjeldsen SE et al (2003) Effects of losartan or atenolol in hypertensive patients without clinically evident vascular disease: a substudy of the LIFE randomized trial. Ann Intern Med 139:169–177

    PubMed  CAS  Google Scholar 

  9. Okin PM, Devereux RB, Jern S et al (2003) Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Circulation 108:684–690

    Article  PubMed  CAS  Google Scholar 

  10. Lindholm LH, Ibsen H, Borsch-Johnsen K et al (2002) Risk of new-onset diabetes in the Losartan Intervention For Endpoint reduction in hypertension study. J Hypertens 20:1879–1886

    Article  PubMed  CAS  Google Scholar 

  11. Lindholm LH, Persson M, Alaupovic P et al (2003) Metabolic outcome during 1 year in newly detected hypertensives: results of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Evaluation (ALPINE study). J Hypertens 21:1563–1574

    Article  PubMed  CAS  Google Scholar 

  12. Montalescot G, Collet JP (2005) Preserving cardiac function in the hypertensive patient: why renal parameters hold the key. Eur Heart J 26:2616–2622

    Article  PubMed  CAS  Google Scholar 

  13. Pfeffer MA, Swedberg K, Granger CB et al (2003) Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet 362:759–766

    Article  PubMed  CAS  Google Scholar 

  14. Lithell H, Hansson L, Skoog I et al (2003) The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hypertens 21:875–886

    Article  PubMed  CAS  Google Scholar 

  15. DREAM Trial Investigators (2006) Effect of ramipril on the incidence of diabetes. N Engl J Med 355:1551–1562

    Article  Google Scholar 

  16. Lewis EJ, Hunsicker LG, Clarke WR et al (2001) Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 345:851–860

    Article  PubMed  CAS  Google Scholar 

  17. Parving HH, Lehnert H, Brochner-Mortensen J et al (2001) The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 345:870–878

    Article  PubMed  CAS  Google Scholar 

  18. Viberti G, Wheeldon NM for the Microalbuminuria Reduction with Valsartan (MARVAL) Study Investigators (2002) Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus. Circulation 106:672–678

    Article  PubMed  CAS  Google Scholar 

  19. Keane WF, Lyle PA (2003) Recent advances in management of type 2 diabetes and nephropathy: lessons from the RENAAL study. Am J Kidney Dis 41(Suppl 3):S22–S25

    PubMed  Google Scholar 

  20. Nakao N, Yoshimura A, Morita H et al (2003) Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomised controlled trial. Lancet 361:117–124

    Article  PubMed  CAS  Google Scholar 

  21. Krum H, Carson P, Farsang C et al (2004) Effect of valsartan added to background ACE inhibitor therapy in patients with heart failure: results from Val-HeFT. Eur J Heart Fail 6:937–945

    Article  PubMed  CAS  Google Scholar 

  22. ESC Task Force (2005) Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005). Eur Heart J 26:1115–1140

    Article  Google Scholar 

  23. Pfeffer MA, McMurray JJ, Velazquez EJ et al (2003) Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. N Engl J Med 349:1893–1906

    Article  PubMed  CAS  Google Scholar 

  24. Dickstein K, Kjekshus J, and the OPTIMAAL Steering Committee, for the OPTIMAAL Study Group (2002) Effects of losartan and captopril on mortality and morbidity in high-risk patients after acute myocardial infarction: the OPTIMAAL randomised trial. Lancet 360:752–760

    Article  PubMed  CAS  Google Scholar 

  25. ACC/AHA Task Force (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction — executive summary. J Am Coll Cardiol 44:671–719

    Article  Google Scholar 

  26. Wachtell K, Lehto M, Gerdts E et al (2005) Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: the Losartan Intervention For End Point Reduction in Hypertension (LIFE) study. J Am Coll Cardiol 45:712–719

    Article  PubMed  CAS  Google Scholar 

  27. Maggioni AP, Latini R, Carson PE et al (2005) Valsartan reduces the incidence of atrial fibrillation in patients with heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT). Am Heart J 149:548–557

    Article  PubMed  CAS  Google Scholar 

  28. Healey JS, Baranchuk A, Crystal E et al (2005) Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis. J Am Coll Cardiol 45:1832–1839

    Article  PubMed  CAS  Google Scholar 

  29. McMurray JJ, Califf R, Holman R et al (2004) Cardiologists should care about glucose: most people with cardiovascular disease or risk factors have diabetes or significant glycaemic abnormalities. Results of screening over 39,000 subjects for NAVIGATOR. Eur Heart J 25(Suppl):239 (abs)

    Google Scholar 

  30. Yusuf S (2002) From the HOPE to the ONTARGET and the TRANSCEND studies: challenges in improving prognosis. Am J Cardiol 89:18A–26A

    Article  PubMed  Google Scholar 

  31. Teo K, Yusuf S, Anderson C et al (2004) Rationale, design, and baseline characteristics of 2 large, simple randomized trials evaluating telmisartan, ramipril and their combination in high-risk patients: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment in ACE Intolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND). Am Heart J 148:52–61

    Article  PubMed  CAS  Google Scholar 

  32. Carson P, Massie BM, McKelvie R et al (2005) The irbesartan in heart failure with preserved systolic function (I-PRESERVE) trial: rationale and design. J Cardiol Fail 11:576–585

    Article  CAS  Google Scholar 

  33. Chaturvedi N, Sjoelie AK, Svensson A for the DIRECT Programme Study Group (2002) The DIabetic Retinopathy Candesartan Trials (DIRECT) Programme, rationale and study design. J Renin Angiotensin Aldosterone Syst 3:255–261

    Article  PubMed  Google Scholar 

  34. The Active Steering Committee; ACTIVE Investigators (2006) Rationale and design of ACTIVE: the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events. Am Heart J 151:1187–1193

    Article  CAS  Google Scholar 

  35. Disertori M, Latini R, Maggioni AP, Delise P (2006) Rationale and design of the GISSI-Atrial Fibrillation Trial: a randomized, prospective, multicentre study on the use of valsartan, an angiotensin II AT1-receptor blocker, in the prevention of atrial fibrillation recurrence. J Cardiovasc Med 7:29–38

    Article  Google Scholar 

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© 2007 Springer-Verlag Italia

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Perrone-Filardi, P. et al. (2007). Role of Angiotensin-Receptor Blockers in the Prevention of Cardiovascular Risk: Clinical Guidelines. In: Gulizia, M.M. (eds) Current News in Cardiology. Springer, Milano. https://doi.org/10.1007/978-88-470-0636-2_52

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  • DOI: https://doi.org/10.1007/978-88-470-0636-2_52

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0635-5

  • Online ISBN: 978-88-470-0636-2

  • eBook Packages: MedicineMedicine (R0)

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