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Reinforces RAS inhibition across CV stages; leaves open optimal modulation strategies for future trials.
A complex chain of events leads to the development of end stage heart disease (fig It starts with seemingly normal subjects with certain risk factors, such as high cholesterol, hypertension, and diabetes. Atherosclerosis is the final common pathway, aVecting blood vessels in the brain, the coronary circulation, and the peripheral circulation. What determines the prognosis for these patients is not the presence of myocardial ischaemia or angina pectoris, but the development of myocardial infarction-a complex disease involving coronary thrombosis, plaque rupture and vasospasm. As cardiac remodelling occurs in heart failure, other mechanisms also come into play. Throughout these stages of heart failure devel-opment, the renin-angiotensin system plays an important role and provides a valuable target for therapeutic intervention.
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Thomas F. Lüscher (2000) studied this question.
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