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Angiotensin II receptor antagonists in the treatment of hypertension
1Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas 75235-8899, USA.
Insights
The Joint National Committee (JNC-VI) provides guidelines for hypertension treatment, including initial drug choices. Angiotensin II receptor antagonists are emerging as potential alternatives due to their favorable side effect profiles.
Area of Science:
- Cardiology
- Pharmacology
Background:
- The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI) outlines cardiovascular risk assessment and antihypertensive drug therapy.
- JNC-VI provides three distinct pathways for selecting initial antihypertensive drug therapy based on patient profiles.
Purpose of the Study:
- To review the current recommendations for hypertension management according to JNC-VI.
- To evaluate the emerging role of angiotensin II receptor antagonists in antihypertensive therapy.
Main Methods:
- Analysis of the JNC-VI report guidelines for hypertension treatment.
- Review of the current clinical status and potential future applications of angiotensin II receptor antagonists.
Main Results:
- JNC-VI categorizes initial antihypertensive therapy selection based on uncomplicated hypertension, specific drug indications, or concomitant conditions.
- Angiotensin II receptor antagonists are currently recommended as alternatives for patients intolerant to angiotensin-converting enzyme (ACE) inhibitors due to cough.
Conclusions:
- The optimal placement of angiotensin II receptor antagonists in initial antihypertensive therapy is still under investigation.
- Ongoing clinical trials are expected to clarify the role of angiotensin II receptor antagonists, potentially establishing them as a favorable first-line option due to their side effect profile.
Abstract:
The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI) includes recommendations for the assessment of overall cardiovascular risk and the need for active antihypertensive drug therapy. Once the decision to initiate antihypertensive drug therapy has been made, JNC-VI recommends one of three paths for the choice of initial therapy: one path for patients with uncomplicated hypertension, another for those with well-defined indications for certain drugs and a third path for patients with various concomitant conditions in which one or another drug has favorable effects. At this time, the place for the newest class of antihypertensive drugs, the angiotensin II receptor antagonists, remains uncertain. Currently, they are considered reasonable alternatives for patients who have a compelling need for an angiotensin-converting enzyme (ACE) inhibitor but develop a cough while taking this medication. When data from ongoing trials become available, angiotensin II receptor antagonists may prove to be a good choice for initial therapy in many patients because of the favorable side effect profile of this class of drugs.