Rationale for ACE Inhibitor — ARB Combination Therapy

Presented By:		Ileana L. Piña, MD, FACC Professor of Medicine Case Western Reserve University School of Medicine VA Quality Scholar Louis Stokes VA Medical Center Cleveland, Ohio

Program Description:	This CME activity consists of an educational component (ie, slides, audio lecture, newsletter) in an electronic format, followed by an online post-test. Estimated time to complete this activity, including review of materials, is 30 minutes.
General Information:	Requirements for Successful Completion: This CME activity consists of an educational component (ie, slides, audio lecture, newsletter) in an electronic format, which is followed by an online post-test. There is no fee to participate in this CME activity or to receive CME credit. Certificates are awarded upon successful completion (80% proficiency) of the post-test. In order to receive credit, participants must view the presentaion in its entirety. Media: Internet Release Date:    March 3, 2008 Expiration Date:  March 2, 2010
Target Audience:	Cardiologists, endocrinologists, and internists with an interest in CV disease
Program Overview:	Hypertension is the principal risk factor for cardiovascular (CV) and end-stage renal disease. Patients rarely present with uncomplicated hypertension; rather, it frequently clusters with dyslipidemia and diabetes, multiplying the risk of major CV events. Due to the large prevalence of CV disease, all clinical practices are faced with the challenge of assessing and managing BP-associated CV risk. Substantial clinical benefit results from tight BP control. Conversely, when BP goals are not met comorbidities are likely to increase. The renin-angiotensin-aldosterone system (RAAS) plays a major role in the pathophysiology of hypertension. Modulation of the RAAS is a well-established approach to BP reduction. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II type 1 (AT1) receptor blockers (ARBs) are increasingly used in clinical cardiology today and particularly in patients at high risk for cardiorenal disease. Although there is considerable debate as to differences between and within classes, they are often used interchangeably. Physicians who are aware of the properties of each will be most successful in treating their patients to goal. This program is designed to increase physician awareness on drug classes that are the most effective as well as the best tolerated and to provide information on optimal strategies that impact the RAAS.
Learning Objectives:	• Understand the rationale for combination ACEI-ARB therapy to better identify patients with complicated hypertension who could benefit from aggressive RAAS therapies • Discuss how ACEI-ARB combination therapy can preserve and increase tissue protective properties of bradykinin beyond monotherapy • Apply combination therapy with ACEIs and ARBs to enhance vascular and metabolic pleiotropic effects beyond blood pressure control alone, in patients at high risk of CV disease
Faculty Disclosure:	The University of Florida College of Medicine has a conflict of interest policy that requires course faculty to disclose any real or apparent commercial financial affiliations related to the content of their presentations/materials. It is not assumed that these financial interests or affiliations will have an adverse impact on faculty presentations; they simply are noted here to fully inform participants. Ileana L. Piña, MD has indicated she has a financial arrangement or affiliation with the National Institutes of Health, the Food and Drug Administration, AstraZeneca, GlaxoSmithKline, Novartis, Scios Inc., and Solvay. The types of affiliations/financial interests are grant/research support, consultant agreements, and honoraria.
Continuing Medical Education Credit:
	Accreditation
	The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
	Credit
	The University of Florida College of Medicine designates this educational activity for a maximum of .50 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
	This continuing education activity was planned in accordance with the ACCME essentials and reviewed by Carl J. Pepine, MD, Program Chair.
	Click here for disclosure and disclaimer information
Commercial Support:	This CME activity is supported by an educational grant from Boehringer Ingelheim.
System Requirements:	In order to view the presentation, your computer must have a media player such as Windows Media Player, Quicktime, or RealOne.
CME Contact:	For any question regarding this Internet CME activity, please contact the Office of Continuing Medical Education at 352-265-8081.
	The University of Florida College of Medicine has received permission to use this copyrighted material within a CME activity on the internet.

Take this presentation with you:
Download this Online Lecture as an MP3 and load it onto your iPod or other portable audio player.
MP3 Audio File
(Right-click and select "Save Target As..." to download)