Combination of drugs acting on the natriuretic system and the renin-angiotensin system in heart failure

Kok H. Chee, Kadirvelu Amudha, Nik A. Hussain, Haron K. Haizal, Anna Maria J. Choy, Chim C. Lang

Research output: Contribution to journalReview ArticleResearchpeer-review

2 Citations (Scopus)


Conventional diuretic agents are very effective agents in relieving volume overload and congestive symptoms in chronic heart failure (CHF). However, they are associated with activation of the renin-anglotensin system (RAS) and the sympathetic nervous system and a reduction in glomerular filtration rate, all of which have been associated with adverse outcomes in CHF. Therefore, there is an increasing interest in drugs that target the natriuretic system without neurohormonal activation and deterioration of renal function. In this review, we will discuss the underlying rationale and evidence behind currently pursued strategies that target the natriuretic system. This includes the administration of natriuretic pepticles (NPs) and strategies that potentiate the NP system, such as neutral endopeptidase inhibition. We will also highlight some potentially important interactions of these strategies with drugs that target the RAS.

Original languageEnglish
Pages (from-to)140-148
Number of pages9
JournalJRAAS - Journal of the Renin-Angiotensin-Aldosterone System
Issue number3
Publication statusPublished - Sep 2003
Externally publishedYes


  • ACE inhibitors
  • Heart failure
  • Natriuretic peptides

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