Clinical consequences of withholding versus administering renin-angiotensin-aldosterone system antagonists in the preoperative period.

Renin-angiotensin system antagonists in the perioperative setting: clinical consequences and recommendations for practice.

There are no existing guidelines supporting the withdrawal or continuation of renin-angiotensin-aldosterone system (RAAS) antagonists in the preoperative setting. RAAS antagonists include ACE inhibitors, angiotensin II receptor subtype 1 blockers and direct renin inhibitors (eg, aliskiren), as well as the aldosterone antagonists. The use of these agents before surgery has been associated with a...

The renin-angiotensin-aldosterone system: approaches to cardiac and renal therapy.

The renin-angiotensin-aldosterone system (RAAS) plays a prominent role in the pathophysiology of cardiac and renal diseases. Aldosterone leads to local effects of vasoconstriction, sodium resorption, and possibly inflammation and fibrosis in several organs. Pharmacologic manipulation of the RAAS may involve renin inhibitors, angiotensin-converting enzyme inhibitors, angiotensin II–receptor bloc...

ACE inhibitors, angiotensin receptor antagonists and bradykinin.

Suppression of Aldosterone Synthesis and Secretion by Ca2+ Channel Antagonists

Aldosterone, a specific mineralocorticoid receptor (MR) agonist and a key player in the development of hypertension, is synthesized as a final product of renin-angiotensin-aldosterone system. Hypertension can be generally treated by negating the effects of angiotensin II through the use of angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin II type 1 receptor antagonists (ARBs). Ho...

AT(1) receptor antagonists-beyond blood pressure control: possible place in heart failure treatment.

The renin-angiotensin system (RAS) plays an important role in heart failure, and renin angiotensin aldosterone blockade has been shown to be of benefit in its treatment. The eVectiveness of angiotensin converting enzyme (ACE) inhibitors has been well established in major trials including CONSENSUS 1, SOLVD, and V-HeFT-II. More recently, the benefits of the aldosterone antagonist spironolactone ...