Bloqueo combinado del SRAA en la enfermedad CV. ¿Qué sabíamos hasta ahora?

This article reviews the therapeutic benefits of using a combination of angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with cardiovascular disease. Clinical trials of what has been termed dual blockade in patients with heart failure have demonstrated small but significant reductions in cardiovascular rehospitalization and mortality. Given after myocardial infarction in patients with heart failure or left ventricular dysfunction, combination treatment was as effective as treatment with either type of agent alone, though there was an increase in the incidence of side effects. However, in clinical practice, the general recommendation that aldosterone antagonists should be administered in cases of advanced heart failure places a limit on the use of dual blockade since triple therapy is contraindicated because of the risk of inducing life-threatening hyperkalemia.