Renoprotection by angiotensin-receptor blockers and ACE inhibitors in hypertension

Abstract

Traditionally, the main outcome endpoints in trials of the management of hypertension have been cardiovascular—stroke, myocardial infarction, and heart failure, and their related morbidity and mortality. Give or take a few small differences, therapy with different classes of anti-hypertensive agents gives similar outcomes provided there is similar blood-pressure reduction.1 The effect of antihypertensive agents on renal variables have, however, been generally ignored. That position has changed with the publication of the results of three trials with hard renal endpoints, such as serum creatinine concentrations and end-stage renal disease (ESRD).