Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK.
Clin Pharmacol Ther. 2013 Oct;94(4):459-67. doi: 10.1038/clpt.2013.135. Epub 2013 Jul 12.
Heart failure (HF) is a very common condition that, despite advances in treatment, carries significant morbidity and mortality. Although there is good evidence for the treatment of HF with reduced ejection fraction (HFrEF), the treatment for HF with preserved ejection fraction (HFpEF) is not well defined. The renin-angiotensin-aldosterone system (RAAS) has been shown to be an effective target in the treatment of HFrEF using angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and aldosterone blockade, although the evidence in HFpEF is less clear. This review aims to look first at the evidence for these drugs, and second at the newer drugs that act on the RAAS, namely, direct renin inhibitors, neutral endopeptidase inhibitors, vasopeptidase inhibitors, and angiotensin receptor blockers.
心力衰竭（HF）是一种非常常见的疾病，尽管在治疗方面取得了进展，但仍具有显著的发病率和死亡率。尽管有充分的证据表明射血分数降低的心力衰竭（HFrEF）的治疗效果，但射血分数保留的心力衰竭（HFpEF）的治疗方法尚未明确。肾素-血管紧张素-醛固酮系统（RAAS）已被证明是使用血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂和醛固酮阻断剂治疗 HFrEF 的有效靶点，尽管 HFpEF 的证据不太明确。本综述旨在首先研究这些药物的证据，其次研究作用于 RAAS 的新型药物，即直接肾素抑制剂、中性内肽酶抑制剂、血管肽酶抑制剂和血管紧张素受体阻滞剂。
