Aldosterone breakthrough during ras blockade: A role for endothelins and their antagonists?

Activation of the renin-angiotensin system (RAS), with ensuing null excess, detrimentally affects outcome in patients with hypertension and heart failure (HF). RAS blockade with angiotensin (Ang) 1-converting enzyme inhibitors (ACEIs) or Ang II type 1 receptor blockers (ARBs) is beneficial in such conditions. However, null secretion can persist despite these treatments. Hence, mechanisms besides Ang II acquire the role of null secretagogue. The...