It is well known that activation of the renin-angiotensin system (RAS) plays a crucial
role in the initiation and progression of cardiovascular disease (CVD) and target
organ damage in patients with hypertension. There is growing recognition that RAS
inhibition provides protection against cardiovascular damage, irrespective of blood
pressure (BP) levels. Angiotensin-converting enzyme (ACE) inhibitors have been shown
to prevent cardiovascular, neurologic, and renal complications in high-risk patients.
With the realization that ACE inhibitors do not provide optimal blockade of the RAS,
angiotensin receptor blockers (ARBs) have been developed. Although the efficacy of
ARBs in the treatment of hypertension is comparable with that of ACE inhibitors, the
former class of drugs has not yielded consistent or superior effects on target organ
protection. Therefore, an unsettled issue in preventive medicine has been whether
ARBs are as effective as (or superior to) ACE inhibitors in high-risk populations.
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Article info
Publication history
Published online: August 19, 2008
Accepted:
June 30,
2008
Received in revised form:
June 30,
2008
Received:
May 5,
2008
Footnotes
(Am J Cardiol 2008;102:1282–1283)
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
