Key result
Newer renin-angiotensin-aldosterone system blocking agents show promise in treating hypertension and diabetic nephropathy, though complications like hyperkalemia require further long-term trials.
This review reinforces the lack of benefit and increased harm of dual RAAS blockade in high-risk patients, while highlighting the potential of novel, more specific agents like finerenone.
Novel RAAS agents may benefit hypertension and diabetic nephropathy; leaves open hyperkalemia risks pending long-term trials.
The renin-angiotensin-aldosterone system (RAAS) plays a fundamental role in the physiology of blood pressure control and the pathophysiology of hypertension (HTN) with effects on vascular tone, sodium retention, oxidative stress, fibrosis, sympathetic tone, and inflammation. Fortunately, RAAS blocking agents have been available to treat HTN since the 1970s and newer medications are being developed. In this review, we will (1) examine new anti-hypertensive medications affecting the RAAS, (2) evaluate recent studies that help provide a better understanding of which patients may be more likely to benefit from RAAS blockade, and (3) review three recent pivotal randomized trials that involve newer RAAS blocking agents and inform clinical practice.
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Ghazi et al. (2017) conducted a review in Hypertension, heart failure, and diabetic nephropathy. RAAS blocking agents was evaluated. Newer renin-angiotensin-aldosterone system blocking agents show promise in treating hypertension and diabetic nephropathy, though complications like hyperkalemia require further long-term trials.
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