Key result
While ACE inhibitors and ARBs provide cardiovascular benefits as monotherapy, the efficacy of combined ACE inhibitor and ARB therapy in high-risk patients awaits confirmation from ongoing trials.
Why the study?
Although trial evidence supports the effectiveness of ACE inhibitor or ARB monotherapy, the benefits of combined ACE inhibitor/ARB therapy in high-risk patients remain unconfirmed.
Does ACE inhibitor and/or ARB therapy reduce cardiovascular events in high-risk patients?
Does ACE inhibitor and/or ARB therapy reduce cardiovascular events in high-risk patients?
This review highlights the established benefits of ACE inhibitor or ARB monotherapy across the cardiovascular continuum while noting that the efficacy of combination therapy in high-risk patients remains to be confirmed.
Reinforces ACEI/ARB benefits across the cardiovascular continuum; leaves open the clinical impact of RAS cellular interactions.
As presented previously in Part 1 of this 2‐part article, many long‐term clinical trials provide overwhelming evidence of the benefits of angiotensin‐converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) across the cardiovascular continuum. Trials also indicate additive or synergistic effects of combination therapy in renal disease and heart failure. Part 2, which is presented here, discusses the extensive interaction of the renin‐angiotensin system (RAS) with the cellular and molecular pathophysiology of cardiovascular disease and the cross‐continuum effects of ARBs and ACE inhibitors, which raises the possibility that RAS inhibition can offer protection in high‐risk patients who do not have symptoms. Although trial evidence supports the effectiveness of monotherapy, the benefits of combined ACE inhibitor/ARB therapy in high‐risk patients await confirmation. Ongoing clinical research will provide new and important information regarding the efficacy of specific combination (ACE inhibitor/ARB) therapies.
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William J. Bommer (2008) conducted a review in Cardiovascular disease, renal disease, and heart failure. ACE inhibitors and ARBs was evaluated. While ACE inhibitors and ARBs provide cardiovascular benefits as monotherapy, the efficacy of combined ACE inhibitor and ARB therapy in high-risk patients awaits confirmation from ongoing trials.
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