Blocking the tissue renin-angiotensin system: the future cornerstone of therapy

The development of angiotensin-converting enzyme inhibitors and selective a ngiotensin type 1 (AT(1))-receptor antagonists has provided new insights in to understanding the mechanism of the renin-angiotensin system (RAS) in the pathophysiology of cardiovascular disease. There is good evidence from met a-analyses that shows that inhibition of the RAS achieves organ protection features that go beyond blood pressure control. Candesartan cilexetil, a ne w angiotensin II receptor antagonist, is characterised by its tight binding to and slow dissociation from the AT(1) receptor, and high antagonistic po tency, resulting in long-lasting antagonistic effects. It is anticipated th at these pharmacological characteristics may bring additional benefits to p atients, not only for the management of essential hypertension but also for the management of end-organ damage.