The renin-angiotensin system (RAS) represents today one of the most strateg
ic targets of the therapy of cardiovascular diseases. During the last 30 ye
ars a number of more or less successful approaches to inhibit the activity
of the RAS have been attempted. In particular, the use of ACE-inhibitiors h
as led to significant improvments in the outcom/treatment of hypertension,
congestive heart failure, ischemic heart disease and nephropathies. On the
other hand, Ace-inhibitors are not specifically targeted to RAS since they
interfere with an enzyme with multiple different substrates. Furthermore, t
he inhibition of ACE does not prevent the formation of angiotensin II throu
gh alternative pathways, and thus the inhibition of RAS is often incomplete
, especially under pathologic conditions stimulating RAS. For these reasons
, the recent discovery of angiotensin ii receptors antagonists, which selec
tively inhibit the action of angiotensin II at the level of the AT1 subtype
receptor, is particularly attracting. This article reviews the background,
the rationale and some of the clinical findings and potential applications
with this new class of compounds.