The renin-angiotensin-aldosterone system: a crossroad from arterial hypertension to heart failure.

The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the regulation of blood pressure and volume homeostasis, promoting critical structural changes in every component of the cardiovascular system, including the heart and blood vessels. Consequently, the RAAS is a crucial therapeut...

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Publicado en:Heart Failure Reviews Vol. 25; no. 1; pp. 31 - 43
Autores principales: Pugliese, Nicola Riccardo, Masi, Stefano, Taddei, Stefano
Formato: research Journal Article
Publicado: Springer Nature Jan2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2020
      vid: 25
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10741-019-09855-5
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        atl: The renin-angiotensin-aldosterone system: a crossroad from arterial hypertension to heart failure.
      aug:
        au:
          Pugliese, Nicola Riccardo
          Masi, Stefano
          Taddei, Stefano
        affil: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
      sug:
        subj:
          Renin-Angiotensin System Drug Effects
          Heart Failure Drug Therapy
          Heart Failure Prevention and Control
          Hypertension Drug Therapy
          Antihypertensive Agents Therapeutic Use
          Human
          Stroke Volume Drug Effects
          Angiotensin-Converting Enzyme Inhibitors Therapeutic Use
          Heart Failure Physiopathology
          Angiotensin II Type I Receptor Blockers Therapeutic Use
          Hypertension Physiopathology
          Blood Pressure Drug Effects
          Clinical Trials
          Aldosterone Antagonists Therapeutic Use
      ab: The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the regulation of blood pressure and volume homeostasis, promoting critical structural changes in every component of the cardiovascular system, including the heart and blood vessels. Consequently, the RAAS is a crucial therapeutic target for several chronic diseases of the cardiovascular system, spanning from arterial hypertension (AH) to heart failure (HF). AH represents a leading risk factor for the development of symptomatic HF, particularly with left ventricle (LV) preserved ejection fraction (HFpEF). LV diastolic dysfunction and cardiac remodelling are the first discernible manifestations of heart disease in patients with AH. Typically, AH develops many years before the diagnosis of overt HF, providing a therapeutic target for preventive strategies. Treatment of AH is based on different classes of antihypertensive drugs, which show differences in their capacity to prevent the evolution towards HF. The blockers of the RAAS are effective drugs to treat AH and prevent HF with reduced ejection fraction (HFrEF), but the evidence of the potential benefits in patients with HFpEF remains limited. In this review, the authors summarise data from several clinical trials of HFpEF and HFrEF, focusing on the mechanisms leading the transition from AH to HF and late complications.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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