Re: Continuing fall in proteinuria after 6-9 months of combined angiotensin converting enzyme inhibitor (ACEI) and angiontensin II receptor antagonist (ARA)

[Guest guest]

Hey Marty :

What is ARA and i know ACEI is ace inhibitor ,please someone give examples of ARA medicine.

thank you

Continuing fall in proteinuria after 6-9 months of combined angiotensin converting enzyme inhibitor (ACEI) and angiontensin II receptor antagonist (ARA)

[Guest guest]

Angiotensin II AT-1 receptor blockers (or antagonist) include Cozaar, Micardis, Diovan and Avapro (all the drugs that end in 'tan, like losartan, irbesartan). The name of that newest class of high BP meds is quite a mouthful, and the medical world doesn't seem to have widely standardised on any abbreviation yet. ARB seems to be the most common one, but I've also seen AIIA, ARA, etc. Judging by clinical trial results, they appear to have to lowest side effect profile of any class of BP meds, and less dry cough than the ACE inhibitors do. Their effect on the kidneys appears to be very similar though. ACE inhibitors block the conversion of angiotensin I into angiotensin II, and ARB's block the angiotensin II at the receptor. So, as far as the kidneys are concerned, the end effect may be exactly the same.

There seems to be two emerging schools of thought: (1) combining an ACEI and an ARB, and (2) dosing up either an ACEI or an ARB far beyond the recommended dosages (like double, and more). Either way, the idea is that a greater dose doesn't lower BP much more, but the renal protective effect may be greater nevertheless. This really hasn't reached the level where it's accepted medical practice yet. For one thing, we don't know what the long term adverse effects might be.

By the way, there is also debate as to whether measuring the effects on proteinuria is the right thing to be looking for when assessing whether a drug is renal-protective, but that's a whole other story.

Pierre

Re: Continuing fall in proteinuria after 6-9 months of combined angiotensin converting enzyme inhibitor (ACEI) and angiontensin II receptor antagonist (ARA)

Hey Marty :

What is ARA and i know ACEI is ace inhibitor ,please someone give examples of ARA medicine.

thank you

[Guest guest]

Dave,

As you can see by Pierre's response, there's no need for me to respond. Pierre is extremely knowledgeable about blood pressure meds and I am not.

Marty

Continuing fall in proteinuria after 6-9 months of combined angiotensin converting enzyme inhibitor (ACEI) and angiontensin II receptor antagonist (ARA)

[Guest guest]

I should be. I've taken enough of them for the past dozen years : )

Pierre

Continuing fall in proteinuria after 6-9 months of combined angiotensin converting enzyme inhibitor (ACEI) and angiontensin II receptor antagonist (ARA)

[Guest guest]

Ok, does this mean that my bp med., called Altace, could actually

help lower my protein, while it helps control my bp and all?? If it

does, YIPPEE!

> Angiotensin II AT-1 receptor blockers (or antagonist) include

Cozaar, Micardis, Diovan and Avapro (all the drugs that end in 'tan,

like losartan, irbesartan). The name of that newest class of high BP

meds is quite a mouthful, and the medical world doesn't seem to have

widely standardised on any abbreviation yet. ARB seems to be the most

common one, but I've also seen AIIA, ARA, etc. Judging by clinical

trial results, they appear to have to lowest side effect profile of

any class of BP meds, and less dry cough than the ACE inhibitors do.

Their effect on the kidneys appears to be very similar though. ACE

inhibitors block the conversion of angiotensin I into angiotensin II,

and ARB's block the angiotensin II at the receptor. So, as far as the

kidneys are concerned, the end effect may be exactly the same.

>

> There seems to be two emerging schools of thought: (1) combining an

ACEI and an ARB, and (2) dosing up either an ACEI or an ARB far

beyond the recommended dosages (like double, and more). Either way,

the idea is that a greater dose doesn't lower BP much more, but the

renal protective effect may be greater nevertheless. This really

hasn't reached the level where it's accepted medical practice yet.

For one thing, we don't know what the long term adverse effects might

be.

>

> By the way, there is also debate as to whether measuring the

effects on proteinuria is the right thing to be looking for when

assessing whether a drug is renal-protective, but that's a whole

other story.

>

> Pierre

> Re: Continuing fall in proteinuria

after 6-9 months of combined angiotensin converting enzyme inhibitor

(ACEI) and angiontensin II receptor antagonist (ARA)

>

>

> Hey Marty :

> What is ARA and i know ACEI is ace inhibitor ,please someone

give examples of ARA medicine.

> thank you

[Guest guest]

Absolutely. Altace (which I've taken) is a very well tested ACEI. Many

clinicial trials involving diabetic and non-diabetic nephropathies have used

Altace (ramipril) as the drug for the test.

Pierre

Re: Continuing fall in proteinuria after 6-9

months of combined angiotensin converting enzyme inhibitor (ACEI) and

angiontensin II receptor antagonist (ARA)

> Ok, does this mean that my bp med., called Altace, could actually

> help lower my protein, while it helps control my bp and all?? If it

> does, YIPPEE!

>

>

>

[Guest guest]

No. I don't think anyone can really say one ACE inhibitor is better than the next. With ramipril, I think the only reason it gets into more clinical trials is that its manufacturer is more agressive about getting itself in those trials. Personally, I think plain old, cheap, generic enalapril is just as good.

Pierre

Re: Continuing fall in proteinuria after 6-9months of combined angiotensin converting enzyme inhibitor (ACEI) andangiontensin II receptor antagonist (ARA)> Ok, does this mean that my bp med., called Altace, could actually> help lower my protein, while it helps control my bp and all?? If it> does, YIPPEE!>> >