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Angiotensin II Receptor Antagonists Alone and Combined with Hydrochlorothiazide

Potential Benefits Beyond the Antihypertensive Effect

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Abstract

Angiotensin II receptor antagonists (angiotensin receptor blockers; ARBs) and thiazide diuretics have an accepted place in the management of hypertension. Most patients require combination therapy with two or more drugs to adequately control blood pressure to targets recommended by European and international guidelines. ARBs and the thiazide diuretic hydrochlorothiazide have complementary modes of action. Fixed-dose combinations of an ARB and low-dose hydrochlorothiazide provide a convenient and effective treatment option for patients who do not achieve blood pressure targets on monotherapy, without compromising the placebo-like tolerability of ARBs. In Europe, fixed-dose combinations with hydrochlorothiazide currently are available for the ARBs candesartan, eprosartan, irbesartan, losartan, telmisartan, and valsartan. Recently, a number of studies have focused on the use of ARBs in monotherapy and in combination therapy, in conditions including congestive heart failure, post-myocardial infarction management, hypertension with cardiovascular risk factors, and diabetic and non-diabetic nephropathy. Evidence from these studies suggests a beneficial role beyond the antihypertensive effect of these therapies in providing protection against cardiovascular, renovascular, and cerebrovascular events.

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Acknowledgments

This review was supported by Takeda Chemical Industries, Japan.

P.A. Meredith has received research grants and honoraria for consultancy from a number of pharmaceutical companies including Abbott, Astra-Zeneca, Bayer, Boehringer-Ingelhiem, GSK, MSD, Pfizer, Servier, and Takeda.

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  1. Department of Medicine and Therapeutics, Division of Cardiovascular and Medical ScienceGardiner Institute, Western Infirmary, Glasgow, G11 6NT, Scotland

    Peter A. Meredith

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Meredith, P.A. Angiotensin II Receptor Antagonists Alone and Combined with Hydrochlorothiazide. Am J Cardiovasc Drugs 5, 171–183 (2005). https://doi.org/10.2165/00129784-200505030-00004

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