Thirty years of renin-angiotensin-aldosterone system inhibition in chronic heart failure

Czech version

Authors: J. Vítovec ¹; J. Špinar ²; L. Špinarová ¹
Authors‘ workplace: I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně ¹; Interní kardiologická klinika LF MU a FN Brno ²
Published in: Kardiol Rev Int Med 2017, 19(3): 187-194

Overview

The paper presents a historical overview of mortality trials on angiotensin-aldosterone system inhibition in patients with chronic heart failure. From the CONSENSUS trial up to the PARADIGM-HF trial it has been shown that ACE inhibitors/ angiotensin II receptor antagonists (AT1-blockers, ARBs, sartans) along with mineralocorticoid receptor blockers, have been the gold standard of treatment. Both direct renin blocker aliskiren and dual blocker enalapril + neprilysin inhibitor proved ineffective; on the other hand, the new dual angiotensin II receptor blocker + neprilysin inhibitor – sacubitril-valsartan is a new therapeutic combination for future treatment of chronic heart failure.

Keywords:
chronic heart failure – ace inhibitors – angiotensin receptor blockers – mineralocorticoid receptor antagonists – aliskiren – omapatrilat – sacubitril/ valsartan

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