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Efficacy and tolerability of candesartan cilexetil in special patient groups
1Department of Medicine, University of Munich, Starnberg Hospital, Germany.
Insights
Candesartan cilexetil effectively lowers blood pressure and is well tolerated across diverse patient groups, including those with diabetes and heart failure. This angiotensin II receptor blocker also reverses hypertension
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Hypertension patient populations are heterogeneous, often presenting with comorbidities.
- Antihypertensive treatments require broad efficacy, good tolerability, and mitigation of target-organ damage.
Purpose of the Study:
- To evaluate the efficacy and tolerability of candesartan cilexetil in various hypertensive patient subgroups.
- To assess the impact of candesartan cilexetil on specific comorbidities and target-organ effects of hypertension.
Main Methods:
- Review of accumulating evidence from clinical studies and large trials.
- Analysis of treatment outcomes in diverse patient groups including women, elderly, diabetics, and those with heart failure or pulmonary disease.
Main Results:
- Candesartan cilexetil demonstrates effective blood pressure lowering and good tolerability in diverse populations.
- No adverse effects on glucose tolerance or lipid profiles in diabetic patients.
- Suitable for patients with pulmonary disease, unlike some other antihypertensives.
- Effective in severe hypertension when combined with other agents.
- Reverses left ventricular hypertrophy and microalbuminuria.
Conclusions:
- Candesartan cilexetil offers effective and well-tolerated antihypertensive therapy for a wide range of patients.
- Its benefits extend to specific patient groups with comorbidities, addressing target-organ damage.
- Placebo-like tolerability observed in large trials is consistent across various patient populations.
Abstract:
Patients with hypertension do not comprise a homogeneous group, and the majority present with a variety of concomitant and associated conditions. Antihypertensive therapies should therefore be effective and well tolerated in a wide range of patients and should, ideally, ameliorate the negative target-organ effects of hypertension, such as atherosclerosis, cardiovascular remodelling and renal impairment. Evidence is accumulating that the new angiotensin II type 1 receptor blocker, candesartan cilexetil, lowers blood pressure effectively and is well tolerated in a variety of patient groups, including women and the elderly. In patients with severe hypertension, a treatment schedule based on candesartan cilexetil, with the addition of diuretic and calcium antagonist therapy as needed, has been found to control blood pressure successfully. Candesartan cilexetil does not affect glucose tolerance or lipid profiles in patients with diabetes mellitus, and it is not associated with any of the side effects of other antihypertensive agents that would make it unsuitable for use in patients with pulmonary disease. Initial clinical studies have indicated that candesartan cilexetil is well tolerated and effective in patients with heart failure. Furthermore, the available evidence shows that treatment with candesartan cilexetil can reverse the negative effects of hypertension on left ventricular hypertrophy and microalbuminuria. It therefore appears that the pronounced efficacy and placebo-like tolerability of candesartan cilexetil, as demonstrated in large clinical trials of patients with mild to moderate hypertension, can be extended to a wide range of specific patient groups.