Combined Angiotensin Receptor Modulation in the Management of XXXX .

@entity1 @entity32 @entity8 @entity101 @entity28 @entity2299 @entity7774 @entity6 @entity633 @entity551 @entity299 @entity209 @entity7743
UNASSIGNED: Cardiovascular and @entity209 , such as @entity101 , insulin resistance, @entity2299 or @entity28 are linked with chronic low-grade @entity32 and dysregulation of the renin- @entity7774 system (RAS). Consequently, RAS inhibition by ACE inhibitors or angiotensin @entity7743 ( @entity7743 ) blockers is the evidence-based standard for cardiovascular risk reduction in high-risk @entity1 , including diabetics with @entity633 . In addition, RAS inhibition reduces the new onset of @entity6 . Yet, the high and increasing prevalence of @entity209 , and the high residual risk even in properly treated @entity1 , calls for additional means of pharmacological intervention. In the past decade, the stimulation of the angiotensin AT2 receptor (AT2R) has been shown to reduce @entity32 , improve @entity299 , enhance insulin sensitivity and increase adiponectin production. Therefore, a concept of dual @entity7743 /AT2R modulation emerges as a putative means for risk @entity209 . The approach employing simultaneous RAS blockade ( @entity7743 ) and RAS stimulation (AT2R) is distinct from previous attempts of double intervention in the RAS by dual blockade. Dual blockade abolishes the @entity7743 -linked RAS almost completely with subsequent risk of @entity551 and @entity551 -related events, i.e. @entity8 . Such complications might be especially prominent in @entity1 with @entity8 or @entity1 with isolated systolic @entity101 and normal-to-low diastolic blood pressure values. In contrast to dual RAS blockade, the add-on of AT2R stimulation does not exert significant blood pressure effects, but it may complement and enhance the anti-inflammatory and antifibrotic/de-stiffening effects of the @entity7743 blockade and improve the metabolic profile. Further studies will have to investigate these putative effects in particular for settings in which blood pressure reduction is not primarily desired.
