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Journal of Renin-Angiotensin-Aldosterone System
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Blocking the renin-angiotensin-aldosterone system or lowering the blood pressure: does EUROPA help?

Judy A Mackay

Department of Medicine, Hillingdon Hospital, Pield Heath Road, Uxbridge, Middlesex, UB8 3NN, UK, judyasever{at}aol.com

The EUropean trial on Reduction Of cardiac events with Perindopril in stable coronary Artery disease (EUROPA) demonstrated that the angiotensin-converting enzyme inhibitor, perindopril, compared with placebo, in patients with established coronary artery disease, reduced cardiovascular endpoints by 20% over a four-year follow-up period. Although the authors of this study claim that the risk reduction was best explained by blockade of the renin-angiotensin-aldosterone system, reference to recent meta-analyses of blood pressure (BP)-lowering trials provides compelling evidence that the benefits observed in the trial could be explained by the 5/2 mmHg BP difference between active and placebo treatments.

Key Words: EUROPA • ACE inhibitors • coronary heart disease

Journal of Renin-Angiotensin-Aldosterone System, Vol. 4, No. 4, 205-206 (2003)
DOI: 10.3317/jraas.2003.033
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