Author/Editor		Šabovič, Mišo
Title		Novi podatki o vplivu ACE-inhibitorjev na upočasnitev ateroskleroze
Translated title		New data on the effect of ACE inhibitors on retarding atherosclerosis
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 43, št. Suppl 1
Publication year		2004
Volume		str. 1-6
Language		slo
Abstract		Inhibitors of the angiotensin converting enzyme (ACE inhibitors) are well established in the treatment of arterial hypertension, heart failure and post-infarction dysfunction of the left ventricle. There is growing evidence that the renin-angiotensin system also plays an important role in the pathogenesis of atherosclerosis. Angiotensin II increases oxidative stress and the consequential production of free radicals within the arterial wall. It is becoming evident that increased oxidative stress is one of the most important processes in atherosclerosis. Free radicals induce and facilitate endothelial dysfunction, inflammation in arterial walls and oxidation of LDL cholesterol. Inhibition of angiotensin II de,creases its pro-atherogenic effects. In large clinical trials (HOPE, EUROPA), ACE inhibitors (ramipril, perindopril) were found to be effective in the prevention of myocardial infarction and stroke, even in patients using aspirin, statins and beta-blockers. In the coming years, the results of other trials exploring the slowing of atherosclerosis with ACE inhibitors will become available. Overall, it is clear that treatment with ACE inhibitors is beneficial in patients with manifest atherosclerosis or high risk for it.
Summary		Inhibitorji angiotenzin-konvertirajočega encima (ACE-inhibitorji) so uveljavljeni v zdravljenju arterijske hipertenzije, srčnega popuščanja in poinfarktni disfunkciji levega prekata. V zadnjih letih se kopičijo dokazi o pomembnosti vloge renin-angiotenzinskega sistema oz. angiotenzina II v procesu ateroskleroze. Glavni pro-aterogeni učinek angiotenzina II je zvečanje oksidativnega stresa v žilni steni in posledično zvečan nastanek prostih radikalov. Vse več je dokazov, da je prav zvečan oksidativni stres eden najpomembnejših mehanizmov v procesu ateroskleroze. Prosti radikali okvarjajo endotelijsko funkcijo, pospešijo vnetje v žilni steni in oksidirajo holesterol LDL. Oviranje angiotenzina II, ki se nahaja v žilni steni, zmanjša njegove pro-aterogene učinke. V kliničnih raziskavah (HOPE, EUROPA) so ugotovili, da zdravljenje z ACE-inhibitorji (ramipril, perindopril) upočasni razvoj aterosklerotičnih sprememb in zmanjša pojavnost srčnega infarkta in možganske kapi. Ugotovitev velja tudi za bolnike, ki jemljejo aspirin, statine in blokatorje beta. V prihodnjih letih pričakujemo še rezultate drugih kliničnih raziskav o vplivu ACE-inhibitorjev na upočasnitev ateroskleroze. Nedvomno pa je, da zdravljenje z ACE-inhibitorji koristi vsem bolnikom z manifestno aterosklerozo ali velikim tveganjem za razvoj le-te.
Descriptors		ATHEROSCLEROSIS ANGIOTENSIN-CONVERTING ENZYME INHIBITORS MYOCARDIAL INFARCTION CEREBRAL INFARCTION OXIDATIVE STRESS FREE RADICALS RENIN-ANGIOTENSIN SYSTEM