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The Evolution of Renin-Angiotensin Blockade: Angiotensin-Converting Enzyme Inhibitors as the Starting Point

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Abstract

The renin-angiotensin system has been a target in the treatment of hypertension for close to three decades. Several medication classes that block specific aspects of this system have emerged as useful therapies, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and, most recently, direct renin inhibitors. There has been a natural history to the development of each of these three drug classes, starting with their use as antihypertensive agents; thereafter, in each case they have been employed as end-organ protective agents. To date, there has been scant evidence to favor angiotensin receptor blockers or direct renin inhibitors over angiotensin-converting enzyme inhibitors in treating hypertension or in affording end-organ protection; thus, angiotensin-converting enzyme inhibitors remain the standard of care when renin-angiotensin system blockade is warranted.

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Sica, D.A. The Evolution of Renin-Angiotensin Blockade: Angiotensin-Converting Enzyme Inhibitors as the Starting Point. Curr Hypertens Rep 12, 67–73 (2010). https://doi.org/10.1007/s11906-010-0091-9

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