An evaluation of the latest evidence relating to renin-angiotensin system
inhibitors.
Author(s): Escobar C(1), Barrios V.
Affiliation(s): Author information:
(1)Hospital La Paz, Department of Cardiology, Madrid, Spain.
Publication date & source: 2013, Expert Opin Drug Metab Toxicol. , 9(7):847-58
INTRODUCTION: In the last few years, a number of important clinical trials have
been completed that have investigated the inhibition of the renin-angiotensin
system. New drugs, focusing on this system, have now emerged as a result.
AREAS COVERED: The authors review the most relevant information available,
reported from the last 5 years, pertaining to the most important clinical trials
on renin-angiotensin system blockers (ARBs). The authors' data review includes
the trials of aliskiren, telmisartan, olmesartan and azilsartan. The authors also
review the possible risk of cancer with ARBs.
EXPERT OPINION: The results of ASPIRE and ALTITUDE trials strongly suggested that
dual inhibition of aliskiren with either ARBS or angiotensin converting enzyme
inhibitors (ACEi) should be avoided. Olmesartan is an effective and safe
antihypertensive agent, but special attention should be paid to high-risk
patients, such as those with coronary disease, to avoid an excessive reduction in
blood pressure. The authors also note that while azilsartan is probably the most
potent ARB, there is still a lack of data regarding potential organ damage and
the incidence of cardiovascular events. Lastly, recent evidence has shown a lack
of a relationship between ARB therapy and the occurrence of cancer.
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