Antelava N A, Kezeli T D, Nikuradze N S, Pachkoriia K Z, Shakulashvili G G
Georgian Med News. 2005 Dec(129):92-8.
Reference data on the function of renin-angiotensin-aldosterone system (RAAS) and pharmacological correction of its hyperactivity are summarized and analyzed in the paper. RAAS plays important role in the development and worsening of hypertension, facilitates proliferation of smooth muscle and heart cells. The hyperactivity of RAAS promotes the development of cardiovascular complications, such as myocardial infarction, stroke, increases cardiovascular mortality and morbidity. Pharmacological correction of RAAS hyperactivity decreases hypertension, prevents occlusion of heart and blood vessels, provides anti-ischemic action, vascular and cardiac protection, improves life style, prevents cardiovascular mortality, such as fatal stroke, myocardial infarction and sudden death. b-blocker inhibitors, angiotensin converting enzyme (ACE) inhibitors, angiotensin AT1-receptors blockers are reviewed as first line therapy of essential hypertension and congestive heart failure. ACT inhibitors, AT1- receptor blockers decrease total cholesterol, LDL, but increase HDL, beta-blockers decrease HDL. AT1-blockers are alternative drugs for treatment of cardiovascular diseases in those cases where ACE inhibitors are contraindicated or intolerance exists.
本文总结并分析了肾素-血管紧张素-醛固酮系统（RAAS）功能的参考数据及其功能亢进的药理学纠正方法。RAAS在高血压的发生和恶化中起重要作用，促进平滑肌和心脏细胞的增殖。RAAS功能亢进会促进心血管并发症的发生，如心肌梗死、中风，增加心血管疾病的死亡率和发病率。对RAAS功能亢进进行药理学纠正可降低血压，预防心脏和血管阻塞，提供抗缺血作用、血管和心脏保护，改善生活方式，预防心血管疾病死亡，如致命性中风、心肌梗死和猝死。β受体阻滞剂、血管紧张素转换酶（ACE）抑制剂、血管紧张素AT1受体阻滞剂被视为原发性高血压和充血性心力衰竭的一线治疗药物。ACE抑制剂、AT1受体阻滞剂可降低总胆固醇、低密度脂蛋白，但会升高高密度脂蛋白，β受体阻滞剂会降低高密度脂蛋白。在ACE抑制剂禁忌或存在不耐受的情况下，AT1受体阻滞剂是治疗心血管疾病的替代药物。
