Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension
Karl AndersenDepartment of Medicine, Division of Cardiology, Landspitali University Hospital, University of Iceland, Reykjavik, IcelandAbstract: The overall purpose of hypertension treatment is 2-fold. First, patients often have symptoms that are related to their high blood pressure and although sub...
Main Author: | |
---|---|
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Dove Medical Press
2009
|
Subjects: | |
Online Access: | https://doaj.org/article/67dc253f6733495c883c4949bfa06164 |
id |
ftdoajarticles:oai:doaj.org/article:67dc253f6733495c883c4949bfa06164 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:67dc253f6733495c883c4949bfa06164 2023-05-15T16:52:15+02:00 Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension Karl Andersen 2009-03-01T00:00:00Z https://doaj.org/article/67dc253f6733495c883c4949bfa06164 EN eng Dove Medical Press https://www.dovepress.com/renin-angiotensin-aldosterone-system-in-the-elderly-rational-use-of-al-peer-reviewed-article-CIA https://doaj.org/toc/1178-1998 1178-1998 https://doaj.org/article/67dc253f6733495c883c4949bfa06164 Clinical Interventions in Aging, Vol Volume 4, Pp 137-151 (2009) Hypertension Renin-Angiotensin System Renin inhibitor aliskiren Geriatrics RC952-954.6 article 2009 ftdoajarticles 2022-12-31T07:20:24Z Karl AndersenDepartment of Medicine, Division of Cardiology, Landspitali University Hospital, University of Iceland, Reykjavik, IcelandAbstract: The overall purpose of hypertension treatment is 2-fold. First, patients often have symptoms that are related to their high blood pressure and although subtle in many instances may be improved dramatically by blood pressure control. The main reason for blood pressure treatment, however, is to reduce the burden of cardiovascular complications and end organ damage related to the condition. This may be considered the ultimate goal of blood pressure treatment. In this respect, actual blood pressure measurements may be seen as surrogate end points as the organ protective effects of two antihypertensive agents may differ significantly even though their blood pressure lowering effects are similar. Thus beta-blockers, once seen as first-line treatment of hypertension for most patients, now are considered as third- or fourth-line agents according to the latest NICE guidelines (National Institute for Health and Clinical Excellence, www.nice.org.uk/CG034). On the other hand, agents that inhibit the activity of the renin-angiotensin-aldosterone system (RAAS) are being established as safe, effective and end organ protective in numerous clinical trials, resulting in their general acceptance as first-line treatment in most patients with stage 2 hypertension. This shift in emphasis from beta-blockers and thiazide diuretics is supported by numerous clinical trials and has proven safe and well tolerated by patients. The impact of this paradigm shift will have to be established in future long-term randomized clinical trials. The optimal combination treatment with respect to end organ protection has yet to be determined. Most combinations will include either a RAAS active agent and calcium channel blocker or two separate RAAS active agents working at different levels of the cascade. In this respect direct renin inhibitors and angiotensin receptor blockers seem particularly promising but ... Article in Journal/Newspaper Iceland Directory of Open Access Journals: DOAJ Articles |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Hypertension Renin-Angiotensin System Renin inhibitor aliskiren Geriatrics RC952-954.6 |
spellingShingle |
Hypertension Renin-Angiotensin System Renin inhibitor aliskiren Geriatrics RC952-954.6 Karl Andersen Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension |
topic_facet |
Hypertension Renin-Angiotensin System Renin inhibitor aliskiren Geriatrics RC952-954.6 |
description |
Karl AndersenDepartment of Medicine, Division of Cardiology, Landspitali University Hospital, University of Iceland, Reykjavik, IcelandAbstract: The overall purpose of hypertension treatment is 2-fold. First, patients often have symptoms that are related to their high blood pressure and although subtle in many instances may be improved dramatically by blood pressure control. The main reason for blood pressure treatment, however, is to reduce the burden of cardiovascular complications and end organ damage related to the condition. This may be considered the ultimate goal of blood pressure treatment. In this respect, actual blood pressure measurements may be seen as surrogate end points as the organ protective effects of two antihypertensive agents may differ significantly even though their blood pressure lowering effects are similar. Thus beta-blockers, once seen as first-line treatment of hypertension for most patients, now are considered as third- or fourth-line agents according to the latest NICE guidelines (National Institute for Health and Clinical Excellence, www.nice.org.uk/CG034). On the other hand, agents that inhibit the activity of the renin-angiotensin-aldosterone system (RAAS) are being established as safe, effective and end organ protective in numerous clinical trials, resulting in their general acceptance as first-line treatment in most patients with stage 2 hypertension. This shift in emphasis from beta-blockers and thiazide diuretics is supported by numerous clinical trials and has proven safe and well tolerated by patients. The impact of this paradigm shift will have to be established in future long-term randomized clinical trials. The optimal combination treatment with respect to end organ protection has yet to be determined. Most combinations will include either a RAAS active agent and calcium channel blocker or two separate RAAS active agents working at different levels of the cascade. In this respect direct renin inhibitors and angiotensin receptor blockers seem particularly promising but ... |
format |
Article in Journal/Newspaper |
author |
Karl Andersen |
author_facet |
Karl Andersen |
author_sort |
Karl Andersen |
title |
Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension |
title_short |
Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension |
title_full |
Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension |
title_fullStr |
Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension |
title_full_unstemmed |
Renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension |
title_sort |
renin-angiotensin-aldosterone system in the elderly: rational use of aliskiren in managing hypertension |
publisher |
Dove Medical Press |
publishDate |
2009 |
url |
https://doaj.org/article/67dc253f6733495c883c4949bfa06164 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Clinical Interventions in Aging, Vol Volume 4, Pp 137-151 (2009) |
op_relation |
https://www.dovepress.com/renin-angiotensin-aldosterone-system-in-the-elderly-rational-use-of-al-peer-reviewed-article-CIA https://doaj.org/toc/1178-1998 1178-1998 https://doaj.org/article/67dc253f6733495c883c4949bfa06164 |
_version_ |
1766042395480162304 |