Schmieder Roland E, Hilgers Karl F, Schlaich Markus P, Schmidt Bernhard M W
Department of Nephrology and Hypertension, University of Erlangen-Nuremberg, 91054 Erlangen, Germany.
Lancet. 2007 Apr 7;369(9568):1208-19. doi: 10.1016/S0140-6736(07)60242-6.
The renin-angiotensin system is a major regulatory system of cardiovascular and renal function. Basic research has revealed exciting new aspects, which could lead to novel or modified therapeutic approaches. Renin-angiotensin system blockade exerts potent antiatherosclerotic effects, which are mediated by their antihypertensive, anti-inflammatory, antiproliferative, and oxidative stress lowering properties. Inhibitors of the system-ie, angiotensin converting enzyme inhibitors and angiotensin receptor blockers, are now first-line treatments for hypertensive target organ damage and progressive renal disease. Their effects are greater than expected by their ability to lower blood pressure alone. Angiotensin receptor blockers reduce the frequency of atrial fibrillation and stroke. Renin-angiotensin system blockade delays or avoids the onset of type 2 diabetes and prevents cardiovascular and renal events in diabetic patients. Thus, blockade of this system will remain a cornerstone of our strategies to reduce cardiovascular risk.
肾素-血管紧张素系统是心血管和肾功能的主要调节系统。基础研究揭示了令人兴奋的新方面，这可能会带来新的或改良的治疗方法。肾素-血管紧张素系统阻断发挥强大的抗动脉粥样硬化作用，这些作用由其降压、抗炎、抗增殖和降低氧化应激的特性介导。该系统的抑制剂，即血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂，现在是高血压靶器官损害和进行性肾病的一线治疗药物。它们的作用大于仅通过降低血压的能力所预期的效果。血管紧张素受体阻滞剂可降低心房颤动和中风的发生率。肾素-血管紧张素系统阻断可延迟或避免2型糖尿病的发生，并预防糖尿病患者的心血管和肾脏事件。因此，阻断该系统仍将是我们降低心血管风险策略的基石。
