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Angiotensin II Receptor Blockers

  • Michael A. Weber
Chapter
Part of the Current Clinical Practice book series (CCP)

Abstract

The angiotensin II (Ang II) receptor antagonists are the most selective blockers of the renin-angiotensin system (RAS) currently available. The efficacy of these drugs is similar to that of the other major antihypertensive drug classes, but they appear to exhibit fewer side effects. Angiotensin receptor blockers (ARBs) selectively block the angiotensin AT1 receptors, leaving AT2 receptors exposed to increased circulating concentrations of Ang II. It is not yet known whether the AT2 receptor is expressed or mediates meaningful hemodynamic or vascular effects in clinical hypertension. ARB and angiotensin-converting enzyme (ACE) inhibitors differ in their interactions with the RAS, bradykinin, and other neurohormonal mediators; the two drug classes have similar hemodynamic effects, but it is not yet known whether they might have differential impacts on clinical outcomes. Although ARBs are still relatively new, several rigorous clinical trials with morbidity and mortality end points are already in progress.

Keywords

Blood Pressure Effect Rigorous Clinical Trial Major Antihypertensive Drug Class Inhibitor Clinical Trial Arterial Wall Hypertrophy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Suggested Readings

  1. Bermann MA, Walsh MF, Sowers JR (1997) Angiotensin-II biochemistry and physiol-ogy: update on angiotensin-II receptor blockers. Cardiovasc Rev 15(11:75–100.Google Scholar
  2. Messerli FH, Weber MA, Brunner HR (1996) Angiotensin II receptor inhibition: a new therapeutic principle. Arch Intern Med 156: 1957–1965.PubMedCrossRefGoogle Scholar
  3. De Gasparo M, Bottari S, Leven NR (1995) Characteristics of angiotensin II receptors and their role in cell and organ physiology. In: Laragh JH, Brenner BM, eds. Hypertension: Pathophysiology, Diagnosis, and Management, 2nd ed., New York: Raven, pp. 1695–1720.Google Scholar
  4. Azizi M, Guyene TT, Chatellier G, Wargon M, Monard J (1997) Additive effects of losartan and enalapril on blood pressure and plasma active renin. Hypertension (21:634–640.Google Scholar
  5. Benz J, Oshrain C, Henry D, Avery C, Chiang YT, Gatlin M (1997) Valsartan, a new angiotensin II receptor antagonist: a double-blind study comparing the incidence of cough with lisinopril and hydrochlorothiazide. J Clin Pharmacol 37 (2): 101–107.PubMedGoogle Scholar
  6. Almazov VA, Shlyakhto EV, Conrady AO, Brodskaya IS, Zaharov DV (1997) Effects of losartan on left ventricular mass and heart rate variability in hypertensive patients. Cardiovasc Drugs Ther 11(Suppl. 21: 406.Google Scholar
  7. Chan INC, Critchley JAJH, Tomlinson B, Chan TYK, Cockram CS (1997) Antihypertensive and anti-albuminuric effects of losartan potassium and felodipine in Chinese elderly hypertensive patients with or without non-insulin-dependent diabetes mellitus. Am J Nephrol 17 (l): 72–80.PubMedCrossRefGoogle Scholar
  8. Paolisso G, Tagliamonte MR, Gambardella A, Manzella D, Gualdiero P, Varricchio G, Verza M, Varricchio M (1997) Losartan mediated improvement in insulin action is mainly due to an increase in non-oxidative glucose metabolism and blood flow in insulin-resistant hypertensive patients. J Hum Hypertens 11(51:307–312.Google Scholar
  9. Pitt B, Segal R, Martinez FA, Meurers G, Cowley AC, Thomas I, Deedwania PC, Ney DE, Snavely DB, Chang PI (1997) Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study ELITE). Lancet 349(9054:747–752.Google Scholar
  10. Weber MA (1997) Angiotensin II receptor antagonists in the treatment of hypertension. Cardiol Rev 5 (2): 72–80.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Michael A. Weber

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