Wood J M, Close P
Pharmaceutical Division, CIBA Geigy, Ltd., Basle, Switzerland.
Cardiovasc Drugs Ther. 1996 Jul;10(3):309-12. doi: 10.1007/BF02627954.
This review explores whether the therapeutic attractiveness of renin inhibitors compared with angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists, is sufficient to warrant continued interest in their development for the treatment of cardiovascular disease. Clinical and experimental data available to date indicate that patients with hypertension and congestive heart failure will benefit from renin inhibition. However, clinical experience is very limited, and extra benefits of renin inhibitors compared with the other blockers of the renin-angiotensin system (RAS) have yet to be demonstrated. Some experimental data in animals and humans point to a greater effect of acute renin inhibition on renal blood flow than other modes of interference with the RAS. Again, the clinical benefits of such an effect, and particularly after long-term treatment, in hypertension and renal disease need to be determined. In today's cost-conscious health setting, only new drugs that bring additional clinical benefits have a good chance of being commercially viable. It remains to be seen whether renin inhibitors will fulfill these criteria.
本综述探讨了与血管紧张素转换酶（ACE）抑制剂和血管紧张素II受体拮抗剂相比，肾素抑制剂的治疗吸引力是否足以保证人们继续对其开发用于治疗心血管疾病感兴趣。迄今为止可得的临床和实验数据表明，高血压和充血性心力衰竭患者将从肾素抑制中获益。然而，临床经验非常有限，与肾素-血管紧张素系统（RAS）的其他阻滞剂相比，肾素抑制剂的额外益处尚未得到证实。动物和人类的一些实验数据表明，急性肾素抑制对肾血流量的影响比其他干扰RAS的方式更大。同样，这种效应在高血压和肾脏疾病中的临床益处，尤其是长期治疗后的益处，仍有待确定。在当今注重成本的医疗环境中，只有带来额外临床益处的新药才有良好的商业可行性机会。肾素抑制剂是否能满足这些标准还有待观察。
