THE CURRENT INSIGHT ON DUAL RENIN-ANGIOTENSIN SYSTEM
BLOCKADE: A DATA REVIEW WITH A FOCUS ON SAFETY
ANDREEA FARCAȘ1, FELICIA GLIGOR2*, CAMELIA BUCȘA1, CRISTINA MOGOȘAN1,
MARIUS BOJIȚĂ1, DAN DUMITRAȘCU3
1Iuliu Hațieganu University of Medicine and Pharmacy, Drug Information Research Center, Pasteur 6, 400349, Cluj-Napoca, Romania
2Lucian Blaga University Sibiu, Faculty of Medicine, Lucian Blaga, 2A, 550169, Sibiu, Romania
3Iuliu Hațieganu University of Medicine and Pharmacy, 2nd Medical Department, Clinicilor 2-4, 400013, Cluj-Napoca, Romania
*corresponding author: felicia.gligor@ulbsibiu.ro
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Abstract:
The renin-angiotensin system (RAS) inhibition plays an important role in the therapeutic approach of the hypertensive
patient, including the prevention of cardiovascular and renal complications disease. For an enhanced clinical effect, there is a
strong biological rationale for dual therapy with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor
blockers (ARBs), dual therapy that has been embraced by many clinicians to obtain a more complete RAS blockade, offering
cardioprotection and renoprotection. However, clinical trials conducted throughout the last decade have provided conflicting
results regarding the benefits and safety of RAS dual blockade in patients with hypertension, heart failure, ischemic heart
disease, renal disease or diabetes. In fact, dual therapy did not reduce mortality, but it was associated with an increased harm,
thus pleading against the use of this association. The present review aims to be an appraisal of the latest evidence on dual
renin-angiotensin system blockade, with a focus on safety.

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