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Letters Dual blockade of the renin-angiotensin system

Authors’ reply to Laragh and Sealey

BMJ 2013; 346 doi: (Published 19 March 2013) Cite this as: BMJ 2013;346:f1689
  1. Franz H Messerli, professor of clinical medicine1,
  2. Harikrishna Makani, fellow in cardiovascular medicine1,
  3. Sripal Bangalore, director of cardiovascular outcomes group, assistant professor of medicine2
  1. 1St Luke’s Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, NY 10019, USA
  2. 2Leon H Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA
  1. messerli.f{at}

We agree with Laragh and Sealey that sodium and volume depletion increase the risk of adverse events of renin-angiotensin system blockade. Indeed, protection against hypotension due to volume depletion is one of the main physiological functions of the renin-angiotensin system in people with normal and high blood pressure.1 2

As the …

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