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The Role of the Renin‐Angiotensin‐Aldosterone System in the Management of Heart Failure
Author(s) -
Rodgers Jo E.,
Patterson J. Herbert
Publication year - 2000
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.20.18.368s.34606
Subject(s) - heart failure , spironolactone , medicine , renin–angiotensin system , cardiology , aldosterone , angiotensin receptor blockers , randomized controlled trial , clinical trial , blood pressure
Numerous clinical trials have highlighted the role of the renin‐angiotensin‐aldosterone (RAA) system in the development and progression of heart failure. Over 30 randomized, controlled trials have evaluated the effects of angiotensin‐converting enzyme (ACE) inhibitors on morbidity and mortality in over 7000 patients with heart failure. Cumulative evidence from these trials shows that these agents significantly reduce mortality and hospitalizations, slow disease progression, and improve exercise tolerance and New York Heart Association class. The Heart Failure Society of America guidelines recommend ACE inhibitors as standard therapy for patients with left ventricular systolic dysfunction. The angiotensin receptor blockers and spironolactone offer alternative and perhaps complimentary mechanisms by which the RAA system may be therapeutically manipulated. The role of these therapies in treating heart failure is discussed.