Skip to main content
padlock icon - secure page this page is secure

Renin-angiotensin system inhibition: how much is too much of a good thing?

Buy Article:

$52.00 + tax (Refund Policy)


Inhibitors of the renin-angiotensin system (RAS) are valuable therapeutic agents for a wide range of clinical conditions. Increasingly, consideration is being given to the combination of angiotensin-converting enzyme (ACE) inhibitors and angiotensin-II receptor (AR) antagonists to obtain more complete inhibition of the RAS than can be achieved by either agent alone. Beta-blockers also inhibit the RAS by inhibiting renin secretion. Whereas the combination of an ACE inhibitor and AR antagonist represents dual RAS inhibition, the combination of both of these agents with beta-blocker therapy represents triple RAS inhibition. Animal studies indicate that complete blockade of the RAS produces adverse effects. Moreover, post-hoc analysis of the recent Valsartan Heart Failure Trial study suggests that the combination of ACE inhibitor and AR antagonist therapies may have an adverse effect in heart failure when combined with beta-blocker therapy. There is therefore a need for caution in the combination of ACE inhibition and AR antagonism, particularly in patients receiving beta-blockers, until the impact of this strategy is evaluated. (Intern Med J 2002; 32: 616−620)
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Keywords: angiotensin-converting enzyme inhibitor; angiotensin-receptor antagonist; beta-blocker; heart failure

Document Type: Research Article

Affiliations: St Vincent's Institute of Medical Research and Department of Medicine, University of Melbourne, Melbourne, Victoria 3065, Australia

Publication date: December 1, 2002

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more