XXXX and @entity740 : Should We Use @entity1482 ?

@entity1 @entity8 @entity712 @entity1369 @entity740 @entity65 @entity204 @entity1482 @entity4144
UNASSIGNED: Half of all @entity204 in @entity1 with @entity740 ( @entity740 ) arise from cardiovascular causes. @entity712 ( @entity712 ) is specifically more frequent with @entity740 . Cardiovascular therapies with proven benefit are often withheld from @entity1 with @entity8 for fear of adverse events. The renin-angiotensin- @entity1369 system (RAAS) has been implicated as an important maladaptive neurohormonal pathway in @entity712 . Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been shown to suppress it ineffectively. Current guidelines support the use of @entity1482 for more comprehensive suppression of the RAAS in @entity712 @entity1 . Most supporting trials have however excluded @entity1 with @entity8 resulting in a dearth of data to support use of @entity1482 in @entity740 @entity1 with @entity712 . Several small studies that prospectively interrogated the benefits of augmented RAAS blockade with @entity1482 in @entity740 @entity1 have shown improvement in predictors of @entity65 . More recently, improved mortality outcomes were demonstrated with the use of @entity1482 in hemodialysis @entity1 . Although reduction in glomerular filtration rate and @entity4144 are potential adverse effects with its use, the available evidence suggests that it is uncommon and serious consequences can be avoided with close monitoring. Studies investigating the optimal @entity1482 dosage in such a setting recommend starting with a low dose and careful uptitration. This review attempts to provide a comprehensive insight into the issues associated with the use of @entity1482 in the setting of concomitant @entity712 and @entity740 .
