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September 1, 2005Expert Opinion on Pharmacotherapy

Inhibition of the renin-angiotensin system and cardio-renal protection: focus on losartan and angiotensin receptor blockade

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Why the study?

Do angiotensin receptor blockers, specifically losartan, provide cardio-renal protection in patients with nephropathy or hypertension?

Population

Patients with proteinuric nephropathies, diabetic and non-diabetic renal diseases, and hypertensive patients…

Comparison

Losartan and other angiotensin receptor… vs Angiotensin-converting enzyme inhibitors…

Design

Review

Authors

APAneliya ParvanovaMario Negri Institute for Pharmacological ResearchCCCarlos ChiurchiuHospital PrivadoPRPiero RuggenentiMario Negri Institute for Pharmacological Research

Discussion

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Implication

Losartan may be preferred over ACE inhibitors for tolerability in hypertensive LVH; leaves open need for prospective head-to-head trials on cerebrovascular outcomes.

Structured PICO

Do angiotensin receptor blockers, specifically losartan, provide cardio-renal protection in patients with nephropathy or hypertension?

P
Population
Patients with proteinuric nephropathies, diabetic and non-diabetic renal diseases, and hypertensive patients with left ventricular hypertrophy
I
Intervention
Losartan and other angiotensin receptor blockers (ARBs), including combination therapy with ACE inhibitors
C
Comparator
Angiotensin-converting enzyme (ACE) inhibitors, atenolol, or single-agent renin-angiotensin system inhibition
O
Outcome
Renoprotective effects and cardiovascular complications (including cerebrovascular events and incident diabetes)

Losartan offers effective cardio-renal protection with a favorable side effect profile compared to ACE inhibitors, and may offer superior protection against cerebrovascular events in hypertensive patients with left ventricular hypertrophy.

Cite This Study

Parvanova et al. (2005) studied this question.

synapsesocial.com/papers/6a83f7fc5dc7077fe9c593e5https://doi.org/10.1517/14656566.6.11.1931

Topics

Cardiovascular prevention
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Optimal dose of losartan for renoprotection in diabetic nephropathy2002 · 70 citations
  2. 2Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol2002 · 5,433 citations
  3. 3Additive Effect of ACE Inhibition and Angiotensin II Receptor Blockade in Type I Diabetic Patients with Diabetic Nephropathy2003 · 209 citations
  4. 4Effects of combination therapy with enalapril and losartan on the rate of progression of renal injury in rats with 5/6 renal mass ablation.1998 · 148 citations
  5. 5Angiotensin-Receptor Blockade versus Converting–Enzyme Inhibition in Type 2 Diabetes and Nephropathy2004 · 920 citations