Blokáda systému renin angiotenzin v léčbě kardiovaskulárních onemocnění

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Title in English Renin-angiotensin system blockade in treating cardiovascular disease
Authors

ŠPINAR Jindřich VÍTOVEC Jiří

Year of publication 2010
Type Article in Periodical
Magazine / Source Intervenční a akutní kardiologie
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords renin; angiotensin; heart failure; ischemic heart disease; aliskiren
Description Current knowledge on renin-angiotensin-aldosterone system and the options of its blockade are summarized. Blockade at the level of converting enzyme (ACE inhibitors = ACE-I) and at the level of receptor (AT1 blockers = ARB) has been an established treatment modality in numerous cardiovascular diseases, particularly heart failure, post myocardial infarction, hypertension or diabetes mellitus. Comparison of ACE inhibitors and AT1 blockers was initially performed in heart failure and post myocardial infarction in the ValHeft and VALIANT trials, respectively; and, subsequently, in secondary prevention of ischemic heart disease in the ONTARGET trial, with all these trials showing equality of both drug groups. Aliskiren, a direct renin blocker that blocks renin at the level of conversion of angiotensinogen to angiotensin I, is in phase III–IV of clinical trials. This agent is tested in the extensive ASPIRE HIGHER program in the same indications in which ACE-I or ARB are administered. In 2009, we reported on three large clinical trials – AVOID in diabetic proteinuria, ALLAY in left ventricular hypertrophy in hypertension and ALLOFT in heart failure. This paper deals with AGELESS, another large trial comparing aliskiren and ramipril in geriatric patients with systolic hypertension.
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