Heart & kidney failure: Who's afraid of renin angiotensin system blockade?

Thirty years after the formulation of the neurohormonal hypothesis by Milton Packer [1], implementation and adherence to therapy for antagonism of neurohormonal overactivity in heart failure (HF) remains one of the greatest challenge in cardiology [2]. One cornerstone of HF therapy is represented by renin-angiotensin system (RAS) blockade either with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB). Up-to-date, however, a significant number of HF patients does not receive any RAS blocker, while in several the target dose is not attained, and this frequently occurs because of an unjustified fear of worsening renal function (WRF) after prescription or uptitration, namely in presence of background chronic kidney disease (CKD) [2].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research