Blood pressure effects of the angiotensin II receptor blocker, losartan.
Blood pressure effects of the angiotensin II receptor blocker, losartan.
复制标题
血管紧张素 II 受体阻滞剂氯沙坦对血压的影响。
DOI：
10.1001/archinte.1995.00430040081010
复制
发表时间：
1995
影响因子：
--
通讯作者：
E. Nelson
中科院分区：
文献类型：
--
作者：
M. Weber;R. Byyny;J. Pratt;E. Faison;D. Snavely;A. Goldberg;E. Nelson
背景
氯沙坦钾是第一个 AT1 受体上血管紧张素 II 的非肽选择性阻滞剂，已被证明具有临床抗高血压作用。本研究的目的是通过动态血压监测来表征氯沙坦的功效和作用持续时间。
方法
该研究针对非黑人高血压患者进行，这些患者的基线未经治疗的临床舒张压为 95 毫米汞柱或更高，且平均 24 小时动态舒张压为 85 毫米汞柱或更高。患者被双盲随机分为四个治疗组：安慰剂组 (n = 32) 或氯沙坦组，50 mg 每日一次 (n = 29)，100 mg 每日一次 (n = 30)，或 50 mg 每日两次 (n = 31)。在基线（停药至少 4 周）和治疗 4 周后测量临床血压和 24 小时动态血压。
结果
通过 24 小时或 12 小时给药间隔（谷值）结束时的临床血压计测量，所有三种氯沙坦剂量在降低收缩压和舒张压方面均显着比安慰剂更有效。通过平均 24 小时动态收缩压/舒张压测量，安慰剂组分别降低了 0.0/0.2 mm Hg，而氯沙坦（50 mg 每日一次、100 mg 每日一次和 50 mg 每日两次）分别降低了 9.2/6.9、9.9/6.4 和 13.2/8.5 mm Hg。所有药物作用均不同于安慰剂 (P < .01)。氯沙坦（50 mg，每天两次）的效果与氯沙坦（100 mg，每天一次）的效果没有显着差异，但正如预期的那样，效果大于氯沙坦（50 mg，每天一次）的效果（P < .05）。在接受单药治疗期间临床舒张压保持在 85 mm Hg 或更高的患者中，在另外 2 周的治疗期间添加氢氯噻嗪 12.5 mg/d，产生了额外的、有临床意义的血压下降，这在所有四个治疗组中都是相似的。氯沙坦治疗组和安慰剂组之间的不良事件发生率没有临床上的重要差异[已纠正]。
结论
动态血压监测几乎消除了抗高血压安慰剂反应，显示氯沙坦（每天一次 50 毫克）以及更高剂量（每天一次 100 毫克和每天两次 50 毫克）的 24 小时疗效明显。这种 AT1 受体阻滞剂具有抗高血压作用，与低剂量利尿剂治疗联合使用时会产生相加作用。氯沙坦总体耐受性良好。
BACKGROUND
Losartan potassium, the first nonpeptide selective blocker of angiotensin II at the AT1 receptor, has been shown to exhibit clinical antihypertensive effects. The aim of the present study was to characterize the efficacy and duration of action of losartan by ambulatory blood pressure monitoring.
METHODS
The study was performed in nonblack hypertensive patients whose baseline untreated clinical diastolic blood pressures were 95 mm Hg or higher and whose average 24-hour ambulatory diastolic blood pressures were 85 mm Hg or higher. Patients were randomized, double-blind, into four treatment groups: placebo (n = 32) or losartan, 50 mg once daily (n = 29), 100 mg once daily (n = 30), or 50 mg twice daily (n = 31). Clinical and 24-hour ambulatory blood pressures were measured at baseline (off treatment for at least 4 weeks) and after 4 weeks of treatment.
RESULTS
By clinical sphygmomanometer measurements at the end of the 24-hour or 12-hour dosing intervals (trough), all three losartan dosages were significantly more effective than placebo at decreasing systolic and diastolic blood pressures. By average 24-hour ambulatory systolic/diastolic blood pressure measurements, the decreases produced were 0.0/0.2 mm Hg for placebo and 9.2/6.9, 9.9/6.4, and 13.2/8.5 mm Hg, respectively, for losartan, 50 mg once daily, 100 mg once daily, and 50 mg twice daily. All drug effects were different from placebo (P < .01). The effects of losartan, 50 mg twice daily, were not significantly different from those of losartan, 100 mg once daily, but, as expected, the effects were greater than those of losartan, 50 mg once daily (P < .05). Addition of hydrochlorothiazide, 12.5 mg/d, during an additional 2-week treatment period in patients whose clinical diastolic blood pressure remained at 85 mm Hg or higher while receiving monotherapy produced additional and clinically meaningful blood pressure decrements that were similar in all four treatment groups. There was no clinically important difference in the incidence of adverse events among the losartan-treated and placebo groups [corrected].
CONCLUSION
Ambulatory blood pressure monitoring, which virtually eliminated antihypertensive placebo responses, demonstrated clear 24-hour efficacy for losartan, 50 mg once daily, as well as for higher doses of 100 mg once daily and 50 mg twice daily. This AT1 receptor blocker had antihypertensive effects that appeared additive when combined with low-dose diuretic therapy. Losartan was generally well tolerated.
C6 神经胶质瘤细胞中介导前列腺素合成的血管紧张素受体的表征。
DOI：
10.1152/ajpregu.1991.260.5.r1000
发表时间：
1991
期刊：
The American journal of physiology
影响因子：
--
作者：
Jaiswal,N;Diz,DI;Tallant,EA;Khosla,MC;Ferrario,CM
通讯作者：
Ferrario,CM
DOI：
10.1001/jama.1988.03720020027031
发表时间：
1988-01
期刊：
JAMA
影响因子：
--
作者：
T. Pickering;G. James;Charlene Boddie;G. Harshfield;S. Blank;J. Laragh
通讯作者：
T. Pickering;G. James;Charlene Boddie;G. Harshfield;S. Blank;J. Laragh