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| Untersuchte Arbeit: Seite: 22, Zeilen: 23-28 |
Quelle: Rumschuessel 2011 Seite(n): 32, Zeilen: 24-29 |
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| Viele Studien belegen, dass mit Hilfe der Blockierung des RAS mit ACE-Inhibitoren oder ARBs die Inzidenz von Schlaganfällen verringert werden kann (66.; 72.; 78.-81.). Darüber hinaus zeigen tierexperimentelle Untersuchungen, dass insbesondere ARBs Blutdruckunabhängige, neuroprotektive Wirkungen vermitteln, welche die Schlaganfallpathophysiologie beeinflussen können (59.; 82.-86.). Unter dieser Vorstellung könnte die Therapie mit einem ARB der Therapie mit einem ACE-Inhibitor überlegen sein.
59. Li J, Culman J, Hörtnagl H, Zaho Y, Gerova N, Timm M et al. Angiotensin AT2 recepro protects against cerebral ischemia-induced neuronal injury. FASEB J 2005, 19;617-619. 66. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus. Results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355:253-259. 72. Dahlöf B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002 März;359(9311):995-1003. 78. Lithell H, Ansson L, Skoog I, Elmfeldt D, Hofmann A, Olofsson B et al. for the SCOPE Study group. The Study on Cognition and Prognosis in the Elderly (SCOPE) principal results of a randomised double-blind intervention trail. J Hypertension 2003:; 21:875- 886. 79. Schrader J, Luders S, Kulschewski A, Hammersen F, Plate K, Berger J et al. for the Moses study group. Morbidity and Mortality After Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: prinzipal results of a prospective randomised controlled study (MOSES). Stroke 2005; 36:1218-1226. 80. Schrader J, Lüders S, Kulschewski A, Berger J, Zidek W, Treib. J et al. on behalf of ACESS Study Group. The ACESS Study evaluation of Acute Candesartan Cilexetil Therapy in Stroke Surviviours. Stroke 2003, 34:1699-1703. 81. Diener HC. Prevention regimen for affectively avoiding second strokes (PRoFESS): rationale and design. Cerebrovas. Dis. 2000; 10:147-150. 82. Dai WJ, Funk A, Herdegen T, Unger T, Culman J. Blockade of central angiotensin AT1 receptors improved neurological outcome and reduces expression of AP-1 transcription factors after focal brain ischemia in rats. Stroke 1999; 30:2391-2398. 83. Lou M, Blume A, Zhao Y, Gohlke P, Deutschl G, Herdegen T, Unger T, Culman J. Sustained blockade of brain AT1 receptors before and after focal cerebral ischemia alleviates neurologic deficits and reduces neuronal injury, apoptosis, and inflammatory responses in the rat. J Cereb Blood Flow Metab. 2004; 24:536-547. 84. Groth W, Blume A, Gohlke P, Unger T, Culman J. Chronic pretreatment with candesartan improves recovery from focal cerebral ischemia in rats. J Hypertens 2003; 21: 2175-2182. 85. Lu Q, Zhu YZ, Wong PT.Angiotensin receptor gene expression in candesartan mediated neuroprotection. Neuroreport 2004; 15:2643-2646. 86. Iwai M, Liu HW, Chen R, Ide A, Okamoto S, Hata R et al. Possible inhibition of focal cerebral ischemia by angiotensin II type 2 receptor stimulation. Circulation 2004; 110:843-848. |
Viele Studien belegen, dass mit Hilfe der Blockierung des RAS mit ACE-Inhibitoren und ARBs die Inzidenz von Schlaganfällen verringert werden kann (70, 72, 73, 75, 146, 167, 168, 169, 170). Darüber hinaus zeigen Tiermodellstudien, dass insbesondere ARBs Blutdruckunabhängige, neuroprotektive Wirkungen vermitteln, welche die Schlaganfallpathophysiologie beeinflussen können (131, 161, 162, 163, 166). Unter dieser Vorstellung könnte die Therapie mit einem ARB der Therapie mit einem ACE-Inhibitor überlegen sein.
70. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensinconverting- enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N. Engl. J. Med 2000 Jan;342(3):145-153. Literaturverzeichnis 132 72. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001 Sep;358(9287):1033-1041. 73. Schrader J, Lüders S, Kulschewski A, et al. Morbidity and Mortality After Stroke, Eprosartan Compared with Nitrendipine for Secondary Prevention: principal results of a prospective randomized controlled study (MOSES). Stroke 2005 Juni;36(6):1218-1226. 75. Yusuf S, Diener H, Sacco RL, et al. Telmisartan to prevent recurrent stroke and cardiovascular events. N. Engl. J. Med 2008 Sep;359(12):1225-1237. 131. Li J, Culman J, Hörtnagl H, et al. Angiotensin AT2 receptor protects against cerebral ischemia-induced neuronal injury. FASEB J 2005 Apr;19(6):617-619. 146. Dahlöf B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002 März;359(9311):995-1003. 161. Walther T, Olah L, Harms C, et al. Ischemic injury in experimental stroke depends on angiotensin II. FASEB J 2002 Feb;16(2):169-176. 162. Iwai M, Liu H, Chen R, et al. Possible inhibition of focal cerebral ischemia by angiotensin II type 2 receptor stimulation. Circulation 2004 Aug;110(7):843-848. 163. Lou M, Blume A, Zhao Y, et al. Sustained blockade of brain AT1 receptors before and after focal cerebral ischemia alleviates neurologic deficits and reduces neuronal injury, apoptosis, and inflammatory responses in the rat. J. Cereb. Blood Flow Metab 2004 Mai;24(5):536-547. 166. Krikov M, Thone-Reineke C, Müller S, Villringer A, Unger T. Candesartan but not ramipril pretreatment improves outcome after stroke and stimulates neurotrophin BNDF/TrkB system in rats. J. Hypertens 2008 März;26(3):544-552. 167. Dahlöf B, Sever PS, Poulter NR, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial- Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005 Sep;366(9489):895-906. 168. Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high Literaturverzeichnis cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004 Juni;363(9426):2022-2031. 169. Yusuf S, Teo KK, Pogue J, et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N. Engl. J. Med 2008 Apr;358(15):1547-1559. 170. Yusuf S, Teo K, Anderson C, et al. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet 2008 Sep;372(9644):1174-1183. |
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