Renin-Angiotensin-Aldosterone System: From History to Practice of a Secular Topic.
Sara H KsiazekLilio HuSebastiano AndòMarkus PirklbauerMarcus D SäemannChiara RuotoloGianluigi ZazaGaetano La MannaLuca De NicolaGert MayerMichele ProvenzanoPublished in: International journal of molecular sciences (2024)
Renin-angiotensin-aldosterone system (RAAS) inhibitors are standard care in patients with hypertension, heart failure or chronic kidney disease (CKD). Although we have studied the RAAS for decades, there are still circumstances that remain unclear. In this review, we describe the evolution of the RAAS and pose the question of whether this survival trait is still necessary to humankind in the present age. We elucidate the benefits on cardiovascular health and kidney disease of RAAS inhibition and present promising novel medications. Furthermore, we address why more studies are needed to establish a new standard of care away from generally prescribing ACEi or ARB toward an improved approach to combine drugs tailored to the needs of individual patients.
Keyphrases
- chronic kidney disease
- end stage renal disease
- angiotensin converting enzyme
- angiotensin ii
- healthcare
- heart failure
- primary care
- quality improvement
- palliative care
- peritoneal dialysis
- ejection fraction
- blood pressure
- newly diagnosed
- prognostic factors
- emergency department
- genome wide
- pain management
- atrial fibrillation
- gene expression
- left ventricular
- patient reported
- chronic pain
- acute heart failure
- case control
- solid state
- health insurance
- cardiac resynchronization therapy