Angiotensin II-receptor antagonists: an overview

Area of Science:

• Pharmacology
• Cardiovascular Medicine
• Nephrology

Background:

• Angiotensin-converting-enzyme (ACE) inhibitors, while effective for hypertension, cause frequent adverse effects like cough.
• The renin-angiotensin system (RAS) is a key target for antihypertensive therapies.
• Angiotensin II (AT-II)-receptor antagonists were developed to provide more complete RAS blockade with improved tolerability.

Purpose of the Study:

• To review the efficacy and safety of Angiotensin II (AT-II)-receptor antagonists.
• To compare AT-II-receptor antagonists with other antihypertensive drug classes, including ACE inhibitors.
• To highlight the role of AT-II-receptor antagonists in managing hypertension, especially in patients intolerant to ACE inhibitors.

Main Methods:

• Review of clinical trials and existing literature on Angiotensin II (AT-II)-receptor antagonists.
• Comparison of efficacy and adverse effect profiles with ACE inhibitors, calcium-channel blockers, and beta-blockers.
• Analysis of blood pressure reduction, tolerability, and cost-effectiveness.

Main Results:

• AT-II-receptor antagonists (losartan, valsartan, irbesartan, candesartan, eprosartan, telmisartan, tasosartan) are as effective as established antihypertensives.
• Adverse effects associated with AT-II-receptor antagonists (dizziness, headache, upper-respiratory-tract infection, cough, GI disturbances) occur at rates similar to placebo.
• These agents effectively reduce both systolic and diastolic blood pressure and are comparable in cost.

Conclusions:

• Angiotensin II (AT-II)-receptor antagonists are a well-tolerated and effective therapeutic option for hypertension.
• They offer a favorable alternative to ACE inhibitors, particularly for patients experiencing adverse effects.
• These antagonists can be used as monotherapy or in combination with other antihypertensive agents.