ARBs and target organ protection

Abstract

Recognition of the role of the renin-angiotensin-aldosterone system (RAAS) in initiating and maintaining hypertension prompted the development of drugs that disrupt the RAAS, notably the angiotensin-converting enzyme (ACE) inhibitors and, more recently, the angiotensin II receptor blockers (ARBs). This article focuses on the use of ARBs in hypertension management and reviews evidence emerging from clinical trials that ARBs offer target organ protection over and above their antihypertensive activity.

A Comprehensive Retrospective Study on the Mechanisms of Cyclic Mechanical Stretch-Induced Vascular Smooth Muscle Cell Death Underlying Aortic Dissection and Potential Therapeutics for Preventing Acute Aortic Aneurysm and Associated Ruptures

“…However, in addition to their hypotensive actions, ARBs also have organ-protecting benefits that contribute to their effectiveness. A particular type of ARB blocks both agonist- and stretch-induced activation [ 83 ]. Olm is a powerful ARB with inverse agonist functions [ 84 ] which can prevent basic and stretch-induced activation of the AT1 receptor [ 83 , 84 , 85 ].…”

“…A particular type of ARB blocks both agonist- and stretch-induced activation [ 83 ]. Olm is a powerful ARB with inverse agonist functions [ 84 ] which can prevent basic and stretch-induced activation of the AT1 receptor [ 83 , 84 , 85 ]. We previously reported that Olm inhibits RASMC migration by inhibiting JNK activation [ 86 ].…”

Cardiovascular Disease in Diabetes

“…There is widespread agreement that the RAS plays a pivotal role in the pathogenesis of insulin resistance and CVD in diabetes and that large clinical trials have demonstrated substantial benefit of the blockade of this system for end-organ protection [93][94][95]. Interruption of the RAS with angiotensin-coverting enzyme inhibitors (ACEIs) or angiotensin II type 1 receptor blockers (ARBs) has been recently shown to prevent the onset of diabetes in hypertensive patients and to reduce cardiovascular and renal disease progression in diabetic patients with hypertension [93][94][95].…”

“…Interruption of the RAS with angiotensin-coverting enzyme inhibitors (ACEIs) or angiotensin II type 1 receptor blockers (ARBs) has been recently shown to prevent the onset of diabetes in hypertensive patients and to reduce cardiovascular and renal disease progression in diabetic patients with hypertension [93][94][95].…”

Efeitos do exercício físico e de um inibidor da enzima conversora de angiotensina na pressão arterial e nos sintomas sugestivos de síndrome das pernas inquietas em ratos espontaneamente hipertensos

“…Uma das vias que podem causar depleção dopaminérgica na hipertensão é a hiperatividade do sistema reninaangiotensina (SRA). O papel do SRA é clivar a angiotensina I para sua forma ativa, a angiotensina II, por meio de seu principal efetor, a enzima conversora da angiotensina (ECA) (Nicholls et al, 2000;Silverstein et al, 2004). Quase todas as ações fisiológicas da angiotensina II, incluindo os efeitos vasoconstritores, estimulação da secreção de aldosterona pela glândula supra-renal, retenção de sal e água, e a estimulação do crescimento são mediados por seu receptor AT1 (Wagenaar et al,2002;Schif frin, 2002).…”