International Journal of Molecular Medical Science, 2025, Vol.15, No.5, 235-243 http://medscipublisher.com/index.php/ijmms 235 Case Study Open Access The Renal Protective Effects of ACEI/ARB Drugs in Elderly Patients with Hypertension YanLou Physicov Med. Tech. Ltd., Zhejiang, Zhuji, 311800, Zhejiang, China Corresponding email: yan.lou@cuixi.org International Journal of Molecular Medical Science, 2025, Vol.15, No.5 doi: 10.5376/ijmms.2025.15.0024 Received: 04 Aug., 2025 Accepted: 12 Sep., 2025 Published: 17 Oct., 2025 Copyright © 2025 Lou, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Lou Y., 2025, The renal protective effects of ACEI/ARB drugs in elderly patients with hypertension, International Journal of Molecular Medical Science, 15(5): 235-243 (doi: 10.5376/ijmms.2025.15.0024) Abstract This study explored the renal protective effects of ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in elderly patients with hypertension. Both types of drugs can effectively lower blood pressure, reduce urine protein, and delay the progression of chronic kidney disease (CKD). ACEIs have a more obvious effect in improving renal function and prolonging life, while ARBs have better tolerance. The safety of treatment can be guaranteed by reasonably monitoring renal function and electrolyte levels. ACEI and ARB remain important treatment options for elderly patients with hypertension to maintain renal function and improve long-term outcomes. Keywords ACE inhibitors; Angiotensin II receptor blockers; Elderly hypertension; Renal protection; Chronic kidney disease 1 Introduction Hypertension is a common and increasingly concerned health problem among the elderly, which significantly increases the risk of chronic kidney disease (CKD) and its development into end-stage kidney disease (ESRD) (Zhang et al., 2020). The renin-angiotensin-aldosterone system (RAAS) plays a key role in the occurrence of hypertension and kidney injury. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers ARBs are generally regarded as first-line antihypertensive drugs because they can not only effectively control blood pressure, but also protect organs, especially the kidneys. International guidelines generally recommend that patients with CKD and hypertension, especially those with proteinuria, use ACEI or ARB to delay renal function decline and reduce cardiovascular risk (Lin et al., 2017). Elderly patients with hypertension are more likely to suffer from kidney damage, but in actual clinical statistics, the occurrence rate is usually not high. Due to concerns about adverse drug reactions and other complications, the treatment of these patients is often insufficient (Alcocer et al., 2023). Studies have pointed out that ACEI and ARB can not only control blood pressure, but also have a good protective effect on the kidneys, reduce urinary protein, delay the progression of chronic kidney disease, and are crucial for the long-term health of elderly patients (Zheng et al., 2019). However, when using these drugs, it is still necessary to carefully assess their advantages and disadvantages. For example, elevated blood potassium and changes in renal function are important issues that need attention in the treatment of elderly patients (Hsu et al., 2014). Clarifying the therapeutic effect, safety and rational use methods of ACEI/ARB in elderly patients with hypertension is of great reference significance for rational clinical drug use and scientific decision-making (Pappoe and Winkelmayer, 2010; Tada et al., 2024). This study will analyze the relevant data on the protective effects of ACEI and ARB on the kidneys of elderly patients with hypertension, and explore the efficacy and safety of these two drugs in delaying the progression of chronic kidney disease, reducing proteinuria, and lowering the probability of adverse reactions in the kidneys and cardiovascular system. This study will also compare the benefits and risks of ACEI and ARB, and investigate adverse reactions such as hyperkalemia. This study aims to identify the problems in the actual clinical use of these drugs, propose further research directions, provide references for clinical medication, assist doctors in scientific treatment, and thereby improve the renal function and overall health of elderly patients with hypertension.
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