Drug class review : final report Direct renin inhibitors, angiotensin converting enzyme inhibitors, and angiotensin II receptor blockers / Susan Norris and Jessica Weinstein.

Format:

Book

Author/Creator:

Norris, Susan L., author.

Weinstein, Jessica, author.

Language:

English

Subjects (All):

Angiotensin converting enzyme--Inhibitors.

Angiotensin converting enzyme.

Physical Description:

1 online resource (144 pages)

Place of Publication:

Portland, Oregon : Oregon Health & Science University, 2010.

Summary:

The renin-angiotensin system is a complex biologic system between the heart, brain, blood vessels, and kidneys that leads to the production of biologically active agents, including angiotensin I and II and aldosterone, which act together to impact a variety of bodily functions including blood vessel tone, sodium balance, and glomerular filtration pressure. The multiple and varied effects of these agents allows the renin-angiotensin system to play a wide role in the pathology of hypertension, cardiovascular health, and renal function. Our ability to begin to intervene upon the complex cycle of hormone and other biochemical agent production within the renin-angiotensin system began with the advent of the first orally active ACE-I (angiotensin converting enzyme inhibitor), captopril, in 1981. AIIRAs (angiotensin II receptor blockers) were developed as an alternative to ACE-I, and block the interaction between angiotensin II and the angiotensin receptor. Losartan, the first commercially available AIIRA, was approved for clinical use in 1995. The goal of this report is to compare the effectiveness and harms between aliskiren and placebo and between AIIRAs and ACEIs in the treatment of diagnosed coronary heart disease, hypertension, left ventricular dysfunction, heart failure, nondiabetic chronic kidney disease, or diabetic nephropathy.

Contents:

Introduction

Purpose and Limitations of Systematic Reviews

Scope and Key Questions

Methods

Inclusion Criteria

Literature Search

Study Selection

Data Abstraction

Validity Assessment

Data Synthesis

Peer Review

Public Comment

Results

Overview

Coronary Heart Disease, Heart Failure, and Left Ventricular Dysfunction

Hypertension

Nondiabetic Chronic Kidney Disease

Diabetic Nephropathy

Serious Harms in Observational Studies: All Populations

Conclusions and Limitations

Summary

References

Appendix A. Glossary

Appendix B. Search strategies

Appendix C. Methods used to assess quality of studies

Appendix D. Excluded trials

Appendix E. Black box warnings for included drugs

Evidence Tables.

Notes:

Description based on publisher supplied metadata and other sources.