cardiovascular risk reduction with renin-angiotensin aldosterone system blockade肾素-血管紧张素醛固酮系统封锁减少患心血管疾病的风险.pdfVIP

Hindawi Publishing Corporation Nursing Research and Practice Volume 2010, Article ID 101749, 7 pages doi:10.1155/2010/101749 Review Article Cardiovascular Risk Reduction with Renin-Angiotensin Aldosterone System Blockade Nancy Houston Miller Stanford Cardiac Rehabilitation Program, 703 Welch Road, Suite F1, Palo Alto, CA 94304, USA Correspondence should be addressed to Nancy Houston Miller, nhm@ Received 2 October 2009; Revised 13 May 2010; Accepted 25 May 2010 Academic Editor: Patricia Davidson Copyright © 2010 Nancy Houston Miller. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This paper examines the evidence supporting treatments within the renin-angiotensin aldosterone system (RAS), the role cardioprotection plays within the management of hypertension, considerations around medication adherence, and the role of the nurse or nurse practitioner in guiding patients to achieve higher hypertension control rates. A large body of data now exists to support the use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) which act on RAS, in the management of hypertension and their effect on cardiovascular risk reduction. Current evidence suggests that inhibition of the RAS is an important target for cardioprotection. RAS inhibition controls blood pressure and also reduces target-organ damage. This is especially important in populations at high-risk for damage including patients with diabetes and those with chronic kidney disease. Both ARBs and ACEIs target the RAS offering important reductions in both BP and target organ damage. 1. Introduction