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1.
Environ Sci Technol ; 48(22): 13280-8, 2014 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-25325669

RESUMO

In 1999 we used the MAGIC (Model of Acidification of Groundwater In Catchments) model to project acidification of acid-sensitive European surface waters in the year 2010, given implementation of the Gothenburg Protocol to the Convention on Long-Range Transboundary Air Pollution (LRTAP). A total of 202 sites in 10 regions in Europe were studied. These forecasts can now be compared with measurements for the year 2010, to give a "ground truth" evaluation of the model. The prerequisite for this test is that the actual sulfur and nitrogen deposition decreased from 1995 to 2010 by the same amount as that used to drive the model forecasts; this was largely the case for sulfur, but less so for nitrogen, and the simulated surface water [NO3(-)] reflected this difference. For most of the sites, predicted surface water recovery from acidification for the year 2010 is very close to the actual recovery observed from measured data, as recovery is predominantly driven by reductions in sulfur deposition. Overall these results show that MAGIC successfully predicts future water chemistry given known changes in acid deposition.


Assuntos
Ácidos/química , Água Subterrânea/química , Modelos Teóricos , Poluentes Químicos da Água/análise , Simulação por Computador , Monitoramento Ambiental/métodos , Europa (Continente) , Previsões , Geografia
2.
Ambio ; 42(5): 577-86, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23288615

RESUMO

Decades of acid deposition have caused acidification of lakes in Sweden. Here we use data for 3000 lakes to run the acidification model MAGIC and estimate historical and future acidification. The results indicate that beginning in about 1920 a progressively larger number of lakes in Sweden fell into the category of "not naturally acidified" (∆pH > 0.4). The peak in acidification was reached about 1985; since then many lakes have recovered in response to lower levels of acid deposition. Further recovery from acidification will occur by the year 2030 given implementation of agreed legislation for emissions of sulphur (S) and nitrogen (N) in Europe. But the number of catchments with soils being depleted in base cations will increase slightly. MAGIC-reconstructed history of acidification of lakes in Sweden agrees well with information on fish populations. Future acidification of Swedish lakes can be influenced by climate change as well as changes in forest harvest practices.


Assuntos
Chuva Ácida , Lagos/química , Modelos Teóricos , Poluentes Atmosféricos , Monitoramento Ambiental , Concentração de Íons de Hidrogênio , Solo/química , Suécia , Árvores
3.
Ambio ; 37(1): 56-63, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18341118

RESUMO

Fluctuations in the 20-year record of nitrate (NO3) and total organic carbon (TOC) concentrations and fluxes in runoff at the small headwater catchment Storgama, southern Norway, were related to climate and acid deposition. The long-term decline in NO3 related to reduced NO3 deposition and increased winter discharge, whereas the long-term increase in TOC related to reduced sulfur deposition. Multiple regression models describing long-term trends and seasonal variability in these records were used to project future concentrations given scenarios of climate change and acid deposition. All scenarios indicated reduced NO3 fluxes and increased TOC fluxes; the largest projected changes for the period 2071-2100 were -86% and +24%, respectively. Uncertainties are that the predicted future temperatures are considerably higher than the historical record. Also, nonlinear responses of ecosystem processes (nitrogen [N] mineralization) to temperature, N-enrichment of soils, and step-changes in environmental conditions may affect future leaching of carbon and N.


Assuntos
Carbono/análise , Clima , Água Doce/química , Nitratos/análise , Poluentes Químicos da Água/análise , Chuva Ácida/análise , Ecossistema , Análise de Regressão , Estações do Ano , Neve/química , Temperatura
4.
Ambio ; 37(1): 29-37, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18341115

RESUMO

We have manipulated the winter-time soil temperature regime of small headwater catchments in a montane heathland area of southern Norway to study the possible effects on concentrations and fluxes of inorganic nitrogen in runoff. The experiments included extra insulation of soils in two catchments to prevent subzero temperatures during winter, and removal of snow in two other catchments to promote soil frost. Increased soil temperatures during winter increased the springtime concentrations and fluxes of ammonium (NH4) and nitrate (NO3) in runoff. By contrast, snow removal with development of significant soil frost showed no systematic effects on mean concentrations or fluxes of inorganic N. The results from our experiments suggest that warmer soils during winter caused by exceptionally mild winters, or alternatively a heavy snowpack, imply a greater risk for inorganic N leaching in this region than a possible increase of soil frost events because of reduced snow cover.


Assuntos
Nitratos/análise , Óxido Nítrico/análise , Compostos de Amônio Quaternário/análise , Neve/química , Solo , Poluentes Químicos da Água/análise , Noruega , Estações do Ano , Temperatura
5.
Ambio ; 37(1): 2-8, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18341112

RESUMO

Projected climate change might increase the deposition of nitrogen by about 10% to seminatural ecosystems in southern Norway. At Storgama, increased precipitation in the growing season increased the fluxes of total organic carbon (TOC) and total organic nitrogen (TON) in proportion to the water flux. In winter, soil temperatures near 0 degrees C, common under a snowpack, induced higher runoff of inorganic nitrogen (N) and lower runoff of TOC. By contrast, soil temperatures below freezing, caused by little snow accumulation (expected in a warmer world), reduced runoff of inorganic N, TON, and TOC. Long-term monitoring data showed that reduced snowpack can cause either decreased or increased N leaching, depending on interactions with N deposition, soil temperature regime, and winter discharge. Seasonal variation in TOC was mainly climatically controlled, whereas deposition of sulfate and nitrate (NO3) explained the long-term TOC increase. Upscaling to the river basin scale showed that the annual flux of NO3 will remain unchanged in response to climate change projections.


Assuntos
Carbono/análise , Clima , Ecossistema , Óxidos de Nitrogênio/análise , Estações do Ano , Ar , Precipitação Química , Conservação dos Recursos Naturais , Água Doce , Nitratos/análise , Noruega , Óxidos/análise , Solo , Enxofre
6.
Ambio ; 37(1): 64-72, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18341119

RESUMO

The mass transport model TEOTIL was used to project nitrate (NO3) fluxes from the Tovdal River basin, southernmost Norway, given four scenarios of climate change. Forests, uplands, and open water currently account for 90% of the NO3 flux. Climate scenarios for 2071-2100 suggest increased temperature by 2-4 degrees C and precipitation by 3-11%. Climate experiments and long-term monitoring were used to estimate future rates of nitrogen (N) leaching. More water will run through the terrestrial catchments during the winter but less will run in the spring. The annual NO3 flux from the Tovdal River to the adjoining Topdalsfjord is projected to remain unchanged, but with more NO3 delivered in the winter and less in the spring. Algal blooms in coastal waters can be expected to occur earlier in the year. Major sources of uncertainty are in the long-term fate of N stored in soil organic matter and the impacts of forest management.


Assuntos
Clima , Água Doce/química , Nitratos/análise , Poluentes Químicos da Água/análise , Monitoramento Ambiental/métodos , Modelos Teóricos , Nitrogênio , Noruega , Chuva/química , Estações do Ano
7.
Environ Pollut ; 242(Pt A): 367-374, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29990944

RESUMO

Chronic high deposition of nitrogen (N) to forest ecosystems can lead to increased leaching of inorganic N to surface waters, enhancing acidification and eutrophication. For 26 years nitrogen has been added as ammonium nitrate (NH4NO3) at 40 kg N ha-1 yr-1 to a whole forested catchment ecosystem at Gårdsjön, Sweden, to experimentally simulate the transition from a N-limited to N-rich state. Over the first 10 years of treatment there was an increasing amount of nitrate (NO3-) and to a lesser extent ammonium (NH4+) lost in runoff, but then N leaching stabilised, and for the subsequent 16 years the fraction of N added lost in runoff remained at 9%. NO3- concentrations in runoff were low in the summer during the first years of treatment, but now are high throughout the year. High frequency sampling showed that peaks in NO3- concentrations generally occurred with high discharge, and were enhanced if high discharge coincided with occasions of N addition. Approximately 50% of the added N has gone to the soil. The added N is equivalent to 140 years of ambient N deposition. At current ambient levels of N deposition there thus appears to be no immediate risk of N saturation at this coniferous forest ecosystem, and by inference to other such N-limited forests in Scandinavia.


Assuntos
Florestas , Nitratos/análise , Nitrogênio/análise , Poluentes Químicos da Água/análise , Ecossistema , Monitoramento Ambiental , Modelos Químicos , Óxidos de Nitrogênio , Países Escandinavos e Nórdicos , Solo , Suécia , Traqueófitas , Árvores
8.
Environ Pollut ; 147(3): 791-9, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17291646

RESUMO

To determine the source of dissolved inorganic nitrogen (N) in runoff, approx. 35kg N enriched with the stable isotope (15)N (2110 per thousand delta(15)N) was added to a mature coniferous forested catchment for one whole year. The total N input was approx. 50kg ha(-1) year(-1). The enrichment study was part of a long-term whole-catchment ammonium nitrate addition experiment at Gårdsjön, Sweden. The (15)N concentrations in precipitation, throughfall, runoff and upper forest floor were measured prior to, during, and 3-9years following the (15)N addition. During the year of the (15)N addition the delta(15)N level in runoff largely reflected the level in incoming N, indicating that the leached NO(3)(-) came predominantly from precipitation. Only 1.1% of the incoming N was lost during the year of the tracer addition. The cumulative loss of tracer N over a 10-year period was only 3.9% as DIN and 1.1% as DON.


Assuntos
Poluentes Ambientais/análise , Nitrogênio/análise , Traqueófitas/química , Árvores/química , Poluentes Atmosféricos/análise , Monitoramento Ambiental/métodos , Nitratos/análise , Isótopos de Nitrogênio/análise , Compostos de Amônio Quaternário/análise , Chuva , Poluentes do Solo/análise , Suécia , Poluentes Químicos da Água/análise
9.
Sci Total Environ ; 603-604: 562-569, 2017 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-28646775

RESUMO

Across much of the northern hemisphere, lakes are at risk of re-acidification due to incomplete recovery from historical acidification and pressures associated with more intensive forest biomass harvesting. Critical load (CL) calculations aimed at estimating the amount of pollutants an ecosystem can receive without suffering adverse consequences are dependent on these factors. Here, we present a modelling study of the potential effects of intensified forest harvesting on re-acidification of a set of 3239 Swedish lakes based on scenarios with varying intensities of forest biomass harvest and acid deposition. There is some evidence that forestry would have caused a certain level of acidification even if deposition remained at 1860 levels. We show that all plausible harvest scenarios delay recovery due to increased rates of base cation removal. Scenario results were used to estimate critical loads for the entire population of lakes in Sweden. The forestry intensity included in critical load calculations is a political decision. After scaling calculations to the national level, it was apparent that a high but plausible forest harvest intensity would lead to an increase in the area of CL exceedances and that even after significant reductions in forest harvest intensity, there would still be areas with CL exceedances. Our results show that forest harvest intensity and regional environmental change must be carefully considered in future CL calculations.


Assuntos
Monitoramento Ambiental , Agricultura Florestal , Lagos/química , Ácidos/análise , Florestas , Concentração de Íons de Hidrogênio , Modelos Teóricos , Suécia , Árvores
10.
Sci Total Environ ; 574: 128-138, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27627688

RESUMO

Many surface waters in Europe suffer from the adverse effects of multiple stresses. The Otra River, southernmost Norway, is impacted by acid deposition, hydropower development and increasingly by climate change. The river holds a unique population of land-locked salmon and anadromous salmon in the lower reaches. Both populations have been severely affected by acidification. The decrease in acid deposition since the 1980s has led to partial recovery of both populations. Climate change with higher temperatures and altered precipitation can potentially further impact fish populations. We used a linked set of process-oriented models to simulate future climate, discharge, and water chemistry at five sub-catchments in the Otra river basin. Projections to year 2100 indicate that future climate change will give a small but measureable improvement in water quality, but that additional reductions in acid deposition are needed to promote full restoration of the fish communities. These results can help guide management decisions to sustain key salmon habitats and carry out effective long-term mitigation strategies such as liming. The Otra River is typical of many rivers in Europe in that it fails to achieve the good ecological status target of the EU Water Framework Directive. The programme of measures needed in the river basin management plan necessarily must consider the multiple stressors of acid deposition, hydropower, and climate change. This is difficult, however, as the synergistic and antagonistic effects are complex and challenging to address with modelling tools currently available.


Assuntos
Mudança Climática , Monitoramento Ambiental , Energia Renovável , Rios/química , Salmão , Ácidos/análise , Animais , Concentração de Íons de Hidrogênio , Noruega
12.
Am J Cardiol ; 117(7): 1127-34, 2016 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-26993976

RESUMO

Left atrial appendage closure with the WATCHMAN device is an alternative to anticoagulation for stroke prevention in selected patients with atrial fibrillation (AF). LA device-related thrombus (DRT) is poorly defined and understood. We aimed to (1) develop consensus echocardiographic diagnostic criteria for DRT; (2) estimate the incidence of DRT; and (3) determine clinical event rates in patients with DRT. In phase 1 (training), a training manual was developed and reviewed by 3 echocardiographers with left atrial appendage closure device experience. All available transesophageal (TEE) studies in the WATCHMAN left atrial appendage system for embolic protection in patients with atrial fibrillation (PROTECT-AF) trial patients with suspected DRT were reviewed in 2 subsequent phases. In phase 2 (primary blind read), each reviewer independently scored each study for DRT, and final echo criteria were developed. Unanimously scored studies were considered adjudicated, whereas all others were reevaluated by all reviewers in phase 3 (group adjudication read). DRT was suspected in 35 of 485 patients by the site investigator, the echocardiography core laboratory, or both; 93 of the individual TEE studies were available for review. In phase 2, 3 readers agreed on 67 (72%) of time points. Based on phases 1 and 2, 5 DRT criteria were developed. In phase 3, studies without agreement in phase 2 were adjudicated using these criteria. Overall, at least 1 TEE was DRT positive in 27 (5.7%) PROTECT-AF patients. Stroke, peripheral embolism, or cardiac/unexplained death occurred in subjects with DRT at a rate of 3.4 per 100 patient-years follow-up. In conclusion, DRT were identified on at least 1 TEE in 27 PROTECT-AF patients, indicating a DRT incidence of 5.7%. Primary efficacy events in patients with DRT occurred at a rate of 3.4 per 100 patient-years follow-up, intermediate in frequency between event rates previously reported for the overall device and warfarin arms in PROTECT-AF.


Assuntos
Apêndice Atrial/cirurgia , Fibrilação Atrial/cirurgia , Trombose Coronária/diagnóstico , Trombose Coronária/epidemiologia , Dispositivos de Proteção Embólica/efeitos adversos , Acidente Vascular Cerebral/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/etiologia , Resultado do Tratamento , Varfarina/uso terapêutico
13.
Environ Pollut ; 136(1): 89-101, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15809111

RESUMO

Relationships between catchment characteristics of 31 alpine lakes and observed trends in lake water concentrations of nitrate were evaluated in the Tatra Mountains. Nitrate concentrations increased from background levels <4 microeql(-1) in the 1930s to maxima (up to 55 microeql(-1)) in the 1980s, after which they declined to 4-44 microeql(-1) by the late 1990s. In-lake nitrate concentrations correlated negatively with parameters characterising catchment-weighted mean pools (CWM; kgm(-2)) of soil, i.e. with percent land cover with meadow and soil depth, and positively with grade of terrain, annual precipitation, and the highest elevation in the catchment. The CWM pool of soil and annual precipitation explained together 65% of the current spatial variability in nitrate concentrations. Denitrification and direct N deposition on surface area explained 14% of the variability. Increased atmospheric N deposition and declining net N retention in soils were responsible for long-term changes in nitrate concentrations. Long-term decline in %N retention in soils decreased along with the estimated decline in C:N ratios (from 21 to 18 on average during the last 70 years). An empirical model linking nitrate concentrations in different types of alpine Tatra Mountain lakes to four independent variables (CWM soil pool, annual precipitation, increased N deposition, and average trend in soil C:N ratios) explained 80% of the observed spatial and temporal nitrate variability over the period 1937-2000.


Assuntos
Ecossistema , Monitoramento Ambiental/métodos , Poluição Ambiental , Água Doce , Nitratos/análise , Poluentes Químicos da Água/análise , Chuva Ácida , Agricultura , Animais , Eutrofização , Polônia , Eslováquia , Fatores de Tempo
15.
Ambio ; 32(4): 275-82, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12956593

RESUMO

The reduced emissions of acidifying sulfur and nitrogen in Europe since the late 1970s will be further reduced when the Gothenburg protocol is fully implemented by 2010. Here we address the consequences for the recovery of acidified terrestrial ecosystems using the acidification model MAGIC applied to 3 large-scale "clean rain" experiments, the so-called roof experiments at Risdalsheia, Norway; Gårdsjön, Sweden, and Klosterhede, Denmark. Implementation of the Gothenburg protocol will initiate recovery of the soils at all 3 sites by rebuilding base saturation. The rate of recovery is small and base saturation increases less than 5% over the next 30 years. A climate-induced increase in storm severity will increase the sea-salt input to the ecosystems. This will provide additional base cations to the soils and more than double the rate of the recovery, but also lead to strong acid pulses following high sea-salt inputs as the deposited base cations exchange with the acidity stored in the soil. Future recovery of soils and runoff at acidified catchments will thus depend on the amount and rate of reduction of acid deposition, and in the case of systems near the coast, the frequency and intensity of sea-salt episodes as well.


Assuntos
Chuva Ácida , Ecossistema , Poluição Ambiental/análise , Agricultura Florestal , Modelos Teóricos , Cloreto de Sódio/análise , Dinamarca , Monitoramento Ambiental , Água Doce/análise , Sedimentos Geológicos/análise , Sedimentos Geológicos/química , Noruega , Água do Mar/análise , Suécia , Tempo (Meteorologia)
16.
Sci Total Environ ; 481: 274-9, 2014 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-24602912

RESUMO

This review compiles available information on the concentrations, sources, fate and toxicity of amines and amine-related compounds in surface waters, including rivers, lakes, reservoirs, wetlands and seawater. There is a strong need for this information, especially given the emergence of amine-based post-combustion CO2 capture technologies, which may represent a new and significant source of amines to the environment. We identify a broad range of anthropogenic and natural sources of amines, nitrosamines and nitramines to the aquatic environment, and identify some key fate and degradation pathways of these compounds. There were very few data available on amines in surface waters, with reported concentrations often below detection and only rarely exceeding 10 µg/L. Reported concentrations for seawater and reservoirs were below detection or very low, while for lakes and rivers, concentrations spanned several orders of magnitude. The most prevalent and commonly detected amines were methylamine (MA), dimethylamine (DMA), ethylamine (EA), diethylamine (DEA) and monoethanolamine (MEAT). The paucity of data may reflect the analytical challenges posed by determination of amines in complex environmental matrices at ambient levels. We provide an overview of available aquatic toxicological data for amines and conclude that at current environmental concentrations, amines are not likely to be of toxicological concern to the aquatic environment, however, the potential for amines to act as precursors in the formation of nitrosamines and nitramines may represent a risk of contamination of drinking water supplies by these often carcinogenic compounds. More research on the prevalence and toxicity of amines, nitrosamines and nitramines in natural waters is necessary before the environmental impact of new point sources from carbon capture facilities can be adequately quantified.


Assuntos
Aminas/toxicidade , Água Doce/química , Poluentes Químicos da Água/toxicidade , Poluição Química da Água/estatística & dados numéricos , Compostos de Anilina/toxicidade , Nitrobenzenos/toxicidade , Nitrosaminas/toxicidade
17.
Environ Sci Process Impacts ; 16(7): 1588-99, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24622900

RESUMO

A model network comprising climate models, a hydrological model, a catchment-scale model for phosphorus biogeochemistry, and a lake thermodynamics and plankton dynamics model was used to simulate phosphorus loadings, total phosphorus and chlorophyll concentrations in Lake Vansjø, Southern Norway. The model network was automatically calibrated against time series of hydrological, chemical and biological observations in the inflowing river and in the lake itself using a Markov Chain Monte-Carlo (MCMC) algorithm. Climate projections from three global climate models (GCM: HadRM3, ECHAM5r3 and BCM) were used. The GCM model HadRM3 predicted the highest increase in temperature and precipitation and yielded the highest increase in total phosphorus and chlorophyll concentrations in the lake basin over the scenario period of 2031-2060. Despite the significant impact of climate change on these aspects of water quality, it is minimal when compared to the much larger effect of changes in land-use. The results suggest that implementing realistic abatement measures will remain a viable approach to improving water quality in the context of climate change.


Assuntos
Agricultura , Mudança Climática , Eutrofização , Lagos/química , Modelos Químicos , Fósforo/análise , Poluentes Químicos da Água/análise , Poluição Química da Água/estatística & dados numéricos , Monitoramento Ambiental , Hidrologia , Noruega , Rios , Movimentos da Água
19.
Environ Pollut ; 159(2): 431-40, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21074916

RESUMO

The role of nitrogen (N) in acidification of soil and water has become relatively more important as the deposition of sulphur has decreased. Starting in 1991, we have conducted a whole-catchment experiment with N addition at Gårdsjön, Sweden, to investigate the risk of N saturation. We have added 41 kg N ha(-1) yr(-1) as NH(4)NO(3) to the ambient 9 kg N ha(-1) yr(-1) in fortnightly doses by means of sprinkling system. The fraction of input N lost to runoff has increased from 0% to 10%. Increased concentrations of NO(3) in runoff partially offset the decreasing concentrations of SO(4) and slowed ecosystem recovery from acid deposition. From 1990-2002, about 5% of the total N input went to runoff, 44% to biomass, and the remaining 51% to soil. The soil N pool increased by 5%. N deposition enhanced carbon (C) sequestration at a mean C/N ratio of 42-59 g g(-1).


Assuntos
Nitratos/análise , Poluentes do Solo/análise , Árvores/metabolismo , Poluentes Químicos da Água/análise , Nitratos/metabolismo , Nitrogênio/análise , Nitrogênio/metabolismo , Solo/análise , Poluentes do Solo/metabolismo , Suécia , Árvores/crescimento & desenvolvimento , Poluentes Químicos da Água/metabolismo
20.
J Clin Hypertens (Greenwich) ; 13(11): 848-55, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22051431

RESUMO

Interruption of the renin-angiotensin-aldosterone system (RAAS) cascade with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or more recently direct renin inhibitors (DRIs) is a safe and effective antihypertensive strategy that is in routine clinical use. The clinical utility of these agents in cardiorenal end-organ protection is increasingly being recognized. Although both ACE inhibitors and ARBs demonstrate substantial benefit in patients with cardiovascular and/or renal disease, considerable evidence indicates that they only partially suppress the RAAS pathway due to feedback upregulation of plasma renin activity. With the goal of providing more comprehensive RAAS blockade, combination ACE inhibitor/ARB therapy has been evaluated. However, this approach has not shown the anticipated improvements in composite cardiovascular and renal outcomes and appears to be associated with significant toxicity. Due to a unique mechanism of action, the combination of a DRI with an ACE inhibitor or ARB may represent an effective end-organ-protective therapeutic strategy.


Assuntos
Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Hipertensão/tratamento farmacológico , Renina/antagonistas & inibidores , Antagonistas de Receptores de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Doenças Cardiovasculares/prevenção & controle , Quimioterapia Combinada , Humanos , Nefropatias/prevenção & controle , Sistema Renina-Angiotensina/efeitos dos fármacos
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