The past, present and future of renin-angiotensin aldosterone system inhibition

Robert J. Mentz; George L. Bakris; Bernard Waeber; John J.V. McMurray; Mihai Gheorghiade; Luis M. Ruilope; Aldo P. Maggioni; Karl Swedberg; Ileana L. Piña; Mona Fiuzat; Christopher M. O'Connor; Faiez Zannad; Bertram Pitt

doi:10.1016/j.ijcard.2012.10.007

The past, present and future of renin-angiotensin aldosterone system inhibition

Robert J. Mentz^*, George L. Bakris, Bernard Waeber, John J.V. McMurray, Mihai Gheorghiade, Luis M. Ruilope, Aldo P. Maggioni, Karl Swedberg, Ileana L. Piña, Mona Fiuzat, Christopher M. O'Connor, Faiez Zannad, Bertram Pitt

^*Corresponding author for this work

Medicine, Cardiology Division

Research output: Contribution to journal › Review article › peer-review

107 Scopus citations

Abstract

The renin-angiotensin aldosterone system (RAAS) is central to the pathogenesis of cardiovascular disease. RAAS inhibition can reduce blood pressure, prevent target organ damage in hypertension and diabetes, and improve outcomes in patients with heart failure and/or myocardial infarction. This review presents the history of RAAS inhibition including a summary of key heart failure, myocardial infarction, hypertension and atrial fibrillation trials. Recent developments in RAAS inhibition are discussed including implementation and optimization of current drug therapies. Finally, ongoing clinical trials, opportunities for future trials and issues related to the barriers and approvability of novel RAAS inhibitors are highlighted.

Original language	English (US)
Pages (from-to)	1677-1687
Number of pages	11
Journal	International Journal of Cardiology
Volume	167
Issue number	5
DOIs	https://doi.org/10.1016/j.ijcard.2012.10.007
State	Published - Sep 1 2013

Funding

G.L.B. is a consultant to Takeda, Abbott, Novartis, Fibrogen, and Diachi Sankyo; and investigator initiated funding from Medtronic, Relapsya, Forest, and Takeda. B.W. received lectures fees and/or serves as a member of speakers' bureaus of Servier, Menarini, Novartis, Pfizer, and AstraZeneca. J.J.V.M. received lecture fees from AstraZeneca and has received research support from Amgen and Johnson & Johnson/Scios. M.G. is a consultant for Abbott, Astellas, AstraZeneca, Bayer Schering, Cardiorentis, CorThera, Cytokinetics, CytoPherx, DebioPharm S.A., Errekappa Terapeutici, GlaxoSmithKline, Ikaria, Intersection Medical, JNJ, Medtronic, Merck, Novartis, Ono Parmaceuticals, Otsuka, Palatin Technologies, Pericor Therapeutics, Protein Design Laboratories, Sanofi-Aventis, Sigma Tau, Solvay, Sticares InterACT, Takeda Pharmaceuticals and Trevena Therapeutics. A.P.M. has consulted for Novartis and has received honoraria from Otsuka. K.S. receives research grants from AstraZeneca, Servier, and Amgen; honoraria from AstraZeneca, Otsuka, Servier, and Amgen; and is a consultant for Cytokinetics, Servier, and Novartis. I.L.P. receives research grants from NIH, serves as a member of speakers' bureaus of Novartis, Otsuka, and as a consultant to the US Food and Drug Administration, GE Healthcare, Novartis, and advisory board for BG-Medicine. F.Z. has received honoraria from and served on advisory boards for Pfizer. B.P. is a consultant to Pfizer, Merck, Novartis, Takeda, Astra Zeneca, Bayer, Lilly, BMS, Cytopherx, Amorcyte, Relypsa, BG-Medicine, Aurasense, and GE-Health Care; stocks options in Relypsa, BG-Medicine, and Aurasense; and grants from Novartis, Forrest Laboratories, and Medtronic. The other authors report no relevant conflicts of interest related to this work.

Keywords

Clinical trials
Heart failure
Hypertension
Myocardial infarction
Renin-angiotensin aldosterone system

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.ijcard.2012.10.007

Cite this

Mentz, R. J., Bakris, G. L., Waeber, B., McMurray, J. J. V., Gheorghiade, M., Ruilope, L. M., Maggioni, A. P., Swedberg, K., Piña, I. L., Fiuzat, M., O'Connor, C. M., Zannad, F., & Pitt, B. (2013). The past, present and future of renin-angiotensin aldosterone system inhibition. International Journal of Cardiology, 167(5), 1677-1687. https://doi.org/10.1016/j.ijcard.2012.10.007

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abstract = "The renin-angiotensin aldosterone system (RAAS) is central to the pathogenesis of cardiovascular disease. RAAS inhibition can reduce blood pressure, prevent target organ damage in hypertension and diabetes, and improve outcomes in patients with heart failure and/or myocardial infarction. This review presents the history of RAAS inhibition including a summary of key heart failure, myocardial infarction, hypertension and atrial fibrillation trials. Recent developments in RAAS inhibition are discussed including implementation and optimization of current drug therapies. Finally, ongoing clinical trials, opportunities for future trials and issues related to the barriers and approvability of novel RAAS inhibitors are highlighted.",

keywords = "Clinical trials, Heart failure, Hypertension, Myocardial infarction, Renin-angiotensin aldosterone system",

author = "Mentz, {Robert J.} and Bakris, {George L.} and Bernard Waeber and McMurray, {John J.V.} and Mihai Gheorghiade and Ruilope, {Luis M.} and Maggioni, {Aldo P.} and Karl Swedberg and Pi{\~n}a, {Ileana L.} and Mona Fiuzat and O'Connor, {Christopher M.} and Faiez Zannad and Bertram Pitt",

note = "Funding Information: G.L.B. is a consultant to Takeda, Abbott, Novartis, Fibrogen, and Diachi Sankyo; and investigator initiated funding from Medtronic, Relapsya, Forest, and Takeda. B.W. received lectures fees and/or serves as a member of speakers' bureaus of Servier, Menarini, Novartis, Pfizer, and AstraZeneca. J.J.V.M. received lecture fees from AstraZeneca and has received research support from Amgen and Johnson & Johnson/Scios. M.G. is a consultant for Abbott, Astellas, AstraZeneca, Bayer Schering, Cardiorentis, CorThera, Cytokinetics, CytoPherx, DebioPharm S.A., Errekappa Terapeutici, GlaxoSmithKline, Ikaria, Intersection Medical, JNJ, Medtronic, Merck, Novartis, Ono Parmaceuticals, Otsuka, Palatin Technologies, Pericor Therapeutics, Protein Design Laboratories, Sanofi-Aventis, Sigma Tau, Solvay, Sticares InterACT, Takeda Pharmaceuticals and Trevena Therapeutics. A.P.M. has consulted for Novartis and has received honoraria from Otsuka. K.S. receives research grants from AstraZeneca, Servier, and Amgen; honoraria from AstraZeneca, Otsuka, Servier, and Amgen; and is a consultant for Cytokinetics, Servier, and Novartis. I.L.P. receives research grants from NIH, serves as a member of speakers' bureaus of Novartis, Otsuka, and as a consultant to the US Food and Drug Administration, GE Healthcare, Novartis, and advisory board for BG-Medicine. F.Z. has received honoraria from and served on advisory boards for Pfizer. B.P. is a consultant to Pfizer, Merck, Novartis, Takeda, Astra Zeneca, Bayer, Lilly, BMS, Cytopherx, Amorcyte, Relypsa, BG-Medicine, Aurasense, and GE-Health Care; stocks options in Relypsa, BG-Medicine, and Aurasense; and grants from Novartis, Forrest Laboratories, and Medtronic. The other authors report no relevant conflicts of interest related to this work. ",

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AU - Gheorghiade, Mihai

AU - Ruilope, Luis M.

AU - Maggioni, Aldo P.

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AU - Fiuzat, Mona

AU - O'Connor, Christopher M.

AU - Zannad, Faiez

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PY - 2013/9/1

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N2 - The renin-angiotensin aldosterone system (RAAS) is central to the pathogenesis of cardiovascular disease. RAAS inhibition can reduce blood pressure, prevent target organ damage in hypertension and diabetes, and improve outcomes in patients with heart failure and/or myocardial infarction. This review presents the history of RAAS inhibition including a summary of key heart failure, myocardial infarction, hypertension and atrial fibrillation trials. Recent developments in RAAS inhibition are discussed including implementation and optimization of current drug therapies. Finally, ongoing clinical trials, opportunities for future trials and issues related to the barriers and approvability of novel RAAS inhibitors are highlighted.

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KW - Hypertension

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The past, present and future of renin-angiotensin aldosterone system inhibition

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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