Ace inhibitors in the treatment of arterial hypertension (literature review)

Abstract

Literature data on the role of the renin-angiotensin-aldosterone system in the pathogenesis of arterial hypertension and the role of angiotensin-converting enzyme inhibitors in the treatment of hypertension have been given.The renin-angiotensin-aldosterone system is the central element in controlling the body's water-salt balance and blood pressure. The main effector link of the renin-angiotensin system is angiotensin II, which causes vasospasm, activates heart contraction, inhibits the production of bradykinin, promotes proliferation, and fibrosis of blood vessels and myocardium, and promotes the synthesis of aldosterone in the glomerular zone of the adrenal cortex.Angiotensin-converting enzyme inhibitors are the mainstay of the treatment of arterial hypertension. They contribute to the correction of hypertension, hypertrophy, remodeling of the left ventricle, endothelial dysfunction, proliferation of arterial smooth muscles, and thrombotic phenomena. The 2018 ESH/ESC guidelines state that the first-line therapy in most patients with hypertension should be a fixed combination of a renin-angiotensin system blocker and a calcium channel blocker or diuretic. Blockade of the renin-angiotensin-aldosterone system is currently considered a gold standard of antihypertensive therapy.The objective is to systematize modern literature data on the role of ACE inhibitors in the treatment of arterial hypertension. Conclusion. To date, the concept of the role of the renin-angiotensin-aldosterone system (RAАS) in the pathogenesis of arterial hypertension and the role of ACE inhibitors in the treatment of hypertension has been formulated.