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. 2023 Feb 23;14:1034170. doi: 10.3389/fphys.2023.1034170

TABLE 1.

Synthetic drugs affecting the renin–angiotensin system and adverse effects caused by the prophylactic treatment leading to reduced patient compliance.

Type of drug Main effect Main adverse effect
Beta-blocker Inhibition of renin release Bradycardia
Decreases the sympathetic tone of CNS Increases LDL-C level and decreases HDL-C level
Reduces cardiac volume Rebounds hypertension
Ri Blocks the angiotensinogen (AG) receptor, which inhibits the angiotensin-I (AT-I) conversion by blocking the binding of renin to AG Persistent cough, hyperkalemia, severe hypotension, angioedema, arthralgia, and diarrhea
ACEi Decreases the blood and tissue concentration of angiotensin-II by blocking angiotensin-1 for angiotensin-2 conversion Cough due to the bradykinin and substance-P release;
contraindicated in pregnancy
 ARB Selectively blocks angiotensin-2 receptors resulting in the inhibition of vasoconstriction Hyperkalemia
 NEPi Blocks the decomposition of natriuretic peptides Angioedema and arrhythmia

RAS, renin–angiotensin system; CNS, central nervous system; LDL-C, low-density lipoprotein fraction of cholesterine; HDL-C, high-density lipoprotein fraction of cholesterine; Ri, renin inhibitor; ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin-II receptor blocker; NEPi, neprilysin inhibitor.