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Therapeutic potential of angiotensin II receptor antagonists

M White1, N Racine, A Ducharme

  • 1Department of Physiology, Montreal Heart Institute, University of Montreal, 5000 Belanger Street E., Montreal, Quebec H1T 1C8, Canada. white@icm.umontreal.ca

Expert Opinion on Investigational Drugs
|January 5, 2002
PubMed

Insights

Angiotensin II (A-II) receptor blockers (ARBs) offer cardiovascular protection by blocking A-II Type I receptors. Emerging evidence suggests ARBs also activate kinin pathways, influencing atherosclerosis and autonomic regulation.

Area of Science:

  • Cardiovascular Physiology
  • Pharmacology

Background:

  • The renin-angiotensin system (RAS) is crucial for cardiovascular homeostasis.
  • Local tissue RAS significantly impacts cardiomyocyte growth, vascular remodeling, and arterial function.
  • RAS influences apoptosis, baroreflex, autonomic responses, coagulation, inflammation, and oxidation.

Purpose of the Study:

  • To review mechanisms of cardiovascular effects of angiotensin and ARBs.
  • To present novel data on ARB roles in atherosclerosis, vascular remodeling, coagulation, and autonomic regulation.
  • To discuss ARB use in heart failure, alone or with ACE inhibitors.

Main Methods:

  • Review of recent literature on angiotensin and ARB cardiovascular effects.
  • Presentation of novel research findings on ARB mechanisms.
  • Discussion of clinical applications of ARBs in heart failure.

Main Results:

  • Angiotensin II Type I (AT(1)) receptor blockade mediates cardioprotective and vascular protective effects.
  • Evidence indicates ARBs activate kinin pathways, contributing to their cardiovascular effects.
  • ARBs impact atherosclerosis development, vascular remodeling, coagulation balance, and autonomic regulation.

Conclusions:

  • Selective AT(1) receptor blockade by ARBs provides cardiovascular benefits.
  • Kinin pathway activation is an emerging mechanism for ARB action.
  • ARBs have significant roles in managing cardiovascular conditions, including heart failure.

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