Gerc Vjekoslav, Buksa Marko
Clinic for Heart Disease and Rheumatism, Clinical Centre University Sarajevo, Bosnia and Herzegovina.
Med Arh. 2010;64(5):295-9.
The renin angiotensin system (RAS) plays a key role in the regulation of cardiovascular function, with angiotensin II being involved in hemodynamic and non-hemodynamic mechanism in the pathophysiology of cardiovascular disease. A number of studies demonstrated that pharamacological modulation of the RAS, either with angiotensin converting (ACE) inhibitor or an angiotensin II receptor blocker (ARB), provides cardiovascular and renal protection. Blockade of the RAS, either with ACE inhibitors or ARBs, decreases cardiovascular morbidity and mortality in high risk patients. ACE inhibitors as well as ARBs are drugs of choice in congestive heart failure, as well as in diabetic nephropathy. Especially, the combined RAS blockade with ACE inhibitors and ARBs was more effective than monotherapy in diabetic or non-diabetic nephropathy with proteinuria. However, this combined RAS blockade was not equally dominant in treatment of hypertension and was not recommended for widespread antihypertensive use.
肾素-血管紧张素系统（RAS）在心血管功能调节中起关键作用，血管紧张素II参与心血管疾病病理生理学中的血流动力学和非血流动力学机制。多项研究表明，使用血管紧张素转换酶（ACE）抑制剂或血管紧张素II受体阻滞剂（ARB）对RAS进行药理学调节可提供心血管和肾脏保护。使用ACE抑制剂或ARB阻断RAS可降低高危患者的心血管发病率和死亡率。ACE抑制剂和ARB都是治疗充血性心力衰竭以及糖尿病肾病的首选药物。特别是，在伴有蛋白尿的糖尿病或非糖尿病肾病中，联合使用ACE抑制剂和ARB阻断RAS比单一疗法更有效。然而，这种联合RAS阻断在高血压治疗中并不同样占优势，不建议广泛用于抗高血压治疗。
