Clinical studies on the blockade of the renin-angiotensin-aldosterone-system.

The clinical value of inhibition of the renin-angiotensin-aldosterone-system (RAAS) in heart failure has clearly been documented for the ACE-inhibitors as well as for the angiotensin-I-receptor blocker (AT1) by extensive intervention studies (AIRE, CONSENSUS, SAVE, ELITE II, ValHeFT and others). The additional specific vascular and renal protection, acting beyond the lowering of blood pressure, has been investigated in the past years in numerous studies in patients with arterial hypertension, often accompanied by diabetes mellitus type II. Whereas for nephroprotection, especially also in additionally present diabetes mellitus type II, study results clearly support the assumption of additional protective effects, which exceed the purely blood-pressure lowering effect; the data available for vascular protection (coronary and cerebral vessels) are insufficient.