Interactions between the Cyclooxygenase Metabolic Pathway and the Renin-Angiotensin-Aldosterone Systems: Their Effect on Cardiovascular Risk, from Theory to the Clinical Practice

Table 1

Data on the outcomes of combined use of ASA and ACE-I, ARB, and MRA in CAD, CHF, and HTN.

	Coronary Artery Disease	Congestive Heart Failure	Hypertension
ASA + ACE-I	Depends on trial: No side effects and reduction in mortality (n=19394) [14] vs. increase in mortality (n=6090) [15]	Reduction of clinical benefit (n=2569) [16, 17], increased number of hospitalizations (n=279 and n=1587) [18]	Dose-dependent: low doses of ASA do not affect RR; high doses (>300mg/d) may result in development of resistant hypertension (n=52) [1]. Reduction in cardiovascular events (n=18790) [19]
ASA + ARB	No side effects (n=41267) [20]	No side effects (n=41267 and n=4576) [20, 21]	Reduction in mortality (n=9193) [22], no changes in RR values (n=17) [23]
ASA + MRA	Reduction in mortality (n=6642) [24, 25]	Reduction in mortality (n=6642) [24, 25]	No changes in RR values, no data regarding mortality (n=17) [23]