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The Long-Term Effects of RAAS Blockade on Renal Function

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Special Issues in Hypertension

Abstract

Chronic kidney disease is frequently observed in patients with arterial hypertension. Microalbuminuria and a decreased estimated glomerular filtration rate (<60 ml/min/1.73 m2) are both accompanied by a significant increase in cardiovascular risk. It is well recognized that the reduction of blood pressure levels contributes to diminish the risk of development and progression of cardiovascular and renal disease. Renin-angiotensin system suppressors, both angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB), have demonstrated favourable effects on cardiovascular and renal prognosis, but some limitations have been described, as is the angiotensin and aldosterone breakthrough. The addition of an ACEi to an ARB or viceversa was initially considered as a way to obtain a stronger suppression of renin-angiotensin-aldosterone system, but recent evidences have shown that the combination of these two classes of drugs does not seem to demonstrate the expected increase in benefit. Recent data show that cardiorenal disease could progress even under chronic renin-angiotensin system blockade, so future studies will be necessary to elucidate which is the ideal management for enhancing renin-angiotensin system suppression with the aim of decreasing cardiorenal damage.

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Authors and Affiliations

  1. Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain

    César Cerezo & Luis Miguel Ruilope

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  1. César Cerezo
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  2. Luis Miguel Ruilope
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Correspondence to César Cerezo .

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Editors and Affiliations

  1. , Internal Medicine, American University of Beirut Medical Ce, Riad El Solh, Beirut, 1107-2020, Lebanon

    Adel E. Berbari

  2. Clinica Medica, Ospedale S. Gerardo, Università di Milano-Bicocca, V .Donizetti 106, Milano, Monza, 20133, Italy

    Giuseppe Mancia

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Cerezo, C., Ruilope, L.M. (2012). The Long-Term Effects of RAAS Blockade on Renal Function. In: Berbari, A., Mancia, G. (eds) Special Issues in Hypertension. Springer, Milano. https://doi.org/10.1007/978-88-470-2601-8_35

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  • DOI: https://doi.org/10.1007/978-88-470-2601-8_35

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2600-1

  • Online ISBN: 978-88-470-2601-8

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