Angiotensin II-receptor antagonists: An overview
Angiotensin II-receptor antagonists: An overview
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DOI：
10.1093/ajhp/57.13.1231
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发表时间：
2000-07-01
影响因子：
2.7
通讯作者：
Jafari, M
中科院分区：
文献类型：
--
作者：
Dina, R;Jafari, M
血管紧张素Ⅱ（AT-II）受体拮抗剂是近年来研究的热点，近年来人们发现了血管紧张素转换酶（ACE）抑制剂，这些抑制剂对高血压有较好的治疗效果，但常伴有咳嗽等不良反应。AT-II-受体拮抗剂被开发为能够更完全地阻断RAS的药物，从而减少ACE抑制剂的不良反应。AT-II受体拮抗剂包括氯沙坦、缬沙坦、厄贝沙坦、坎地沙坦、依普罗沙坦、替米沙坦和他索沙坦。多项临床试验表明，AT-Ⅱ受体拮抗剂在治疗高血压方面与钙通道阻滞剂、β受体阻滞剂和ACE抑制剂一样有效，且不良反应较少。AT-Ⅱ受体拮抗剂的副作用头晕、头痛、上呼吸道感染、咳嗽和胃肠道紊乱的发生率与安慰剂相同。在AT-II受体拮抗剂中，仅坎地沙坦与地高辛、华法林和氢氯噻嗪存在任何临床上重要的相互作用。所有可用的AT-II受体拮抗剂似乎在降低收缩压和舒张压方面同样有效，并且它们的成本相当。目前，AT-Ⅱ受体拮抗剂用于不能耐受ACE抑制剂的患者的单药治疗或与其他抗高血压药物联合使用，血管紧张素Ⅱ受体拮抗剂具有良好的耐受性，在降低血压方面与ACE抑制剂一样有效。
Angiotension II (AT-II)-receptor antagonists are reviewed.Research focused on blocking the renin-angiotensin system (RAS) led to the discovery of angiotensin-converting-enzyme (ACE) inhibitors, which are effective in the treatment of hypertension but are associated with a high frequency of cough and other adverse effects. AT-II-receptor antagonists were developed as agents that would more completely block the RAS and thus decrease the adverse effects seen with ACE inhibitors. AT-II-receptor antagonists include losartan, valsartan, irbesartan, candesartan, eprosartan, telmisartan, and tasosartan. Several clinical trials have demonstrated that AT-II-receptor antagonists are as effective as calcium-channel blockers, beta-blockers, and ACE inhibitors in the treatment of hypertension and induce fewer adverse effects. The adverse effects of AT-II-receptor antagonists-dizziness, headache, upper-respiratory-tract infection, cough, and gastrointestinal disturbances-occur at about the same rate as with placebo. Of the AT-II-receptor antagonists, only candesartan has any clinically important interactions with digoxin, warfarin, and hydrochlorothiazide. All available AT-II-receptor antagonists seem to be equally effective in reducing both systolic and diastolic blood pressure, and they are comparable in cost. Currently, AT-ii-receptor antagonists are used either as monotherapy in patients who cannot tolerate ACE inhibitors or in combination with other antihypertensive agents.Angiotensin II-receptor antagonists are well tolerated and are as effective as ACE inhibitors in decreasing blood pressure.