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(Hypertension. 1999;34:987-996.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Statins and Blockers of the Renin-Angiotensin System

Vascular Protection Beyond Their Primary Mode of Action

Agostino Faggiotto; Rodolfo Paoletti

From the Institute of Pharmacological Sciences, University of Milan, Italy.

Correspondence to Rodolfo Paoletti, MD, PhD, Institute of Pharmacological Sciences, University of Milan, Via Balzaretti, 9, I-20133, Milan, Italy. E-mail Rodolfo.Paoletti{at}unimi.it

Abstract—In addition to their primary mode of action, statins and blockers of the renin-angiotensin system possess common additional properties that are under active investigation. The inhibition of cellular proliferation, the restoration of endothelial activity, the inhibition of platelet reactivity, and an antioxidant potential are only a few examples of shared effects that target the arterial wall. These and other properties may eventually become exploited for the improved treatment of cardiovascular diseases and of other diseases apparently unrelated to the cardiovascular field, including inflammation and cancer. This review analyzes the current knowledge on the pleiotropic properties of these classes of drugs. Direct comparison indicates that study of the associations among these drugs may eventually disclose additive or synergistic effects that, perhaps even at lower dosages, may provide improved vascular protection and a strong alliance against several atherogenic mechanisms.

Key Words: statins • renin-angiotensin system • receptors, angiotensin II • angiotensin-converting enzyme inhibitors • atherosclerosis • coronary disease • pleiotropy

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