Skip Navigation



European Heart Journal Advance Access published online on July 8, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi414
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
26/24/2616    most recent
ehi414v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Montalescot, G.
Right arrow Articles by Collet, J.-P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Montalescot, G.
Right arrow Articles by Collet, J.-P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received December 22, 2004
Revised May 10, 2005
Accepted June 16, 2005

Review

Preserving cardiac function in the hypertensive patient: why renal parameters hold the key

Gilles Montalescot 1* and Jean-Philippe Collet 1

1 Cardiac Care Unit, Institut de Cardiologie, Centre Hospitalier Universitaire Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75013 Paris, France

* To whom correspondence should be addressed.
Gilles Montalescot, E-mail: gilles.montalescot{at}psl.ap-hop-paris.fr


  Abstract

The relationship between cardiovascular and renal pathologies is well recognized in advanced nephropathy and heart failure, but in early disease it has received less attention. Consequently, microalbuminuria screening and interventions that treat early nephropathy remain under-utilized cardioprotective strategies in the hypertensive patient. Agents that delay the progression of renal disease are likely to be cardioprotective by lessening the systemic consequences of renal dysfunction and may have additional cardioprotective effects by exerting beneficial effects on endothelia elsewhere in the body and within the heart. A critical driving factor within both renal and wider cardiovascular pathologies is overactivation of the renin-angiotensin-aldosterone system (RAAS). Accordingly, RAAS-directed antihypertensive agents including both angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) have been demonstrated to have renoprotective effects. In major prospective trials, two ARBs, losartan and irbesartan, have been demonstrated to be renoprotective in patients with frank proteinuria, and one ARB, irbesartan, has been shown to have renoprotective properties in patients with microalbuminuria. For patients with incipient or frank renal dysfunction, an aggressive RAAS-based approach to hypertension management, combining potent blood pressure control with proven renoprotection, may therefore constitute a key component of therapy targeted towards long-term cardioprotection.

Keywords: Cardiovascular disease; Hypertension; Microalbuminuria; Renin-angiotensin-aldosterone system; Angiotensin receptor blockers; ACE-inhibitors.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
M. J. Postma and D. de Zeeuw
The economic benefits of preventing end-stage renal disease in patients with type 2 diabetes mellitus
Nephrol. Dial. Transplant., October 1, 2009; 24(10): 2975 - 2983.
[Full Text] [PDF]

Home page
 Journal of Renin-Angiotensin-Aldosterone SystemHome page
G. Nickenig, J. Ostergren, and H. Struijker-Boudier
Clinical Evidence for the Cardiovascular Benefits of Angiotensin Receptor Blockers
Journal of Renin-Angiotensin-Aldosterone System, March 1, 2006; 7(1_suppl): S1 - S7.
[Abstract] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.