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[Effects of angiotensin receptor inhibitors on cardiovascular endpoints--current and future evidence]
1Országos Korányi Tbc és Pulmonológiai Intézet, Kardiológiai Osztály.
Insights
Controlling hypertension and organ damage reduces cardiovascular mortality. Telmisartan effectively reduces left ventricular hypertrophy (LVH) even at low doses, and combination therapies are under investigation.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Pharmacology
Context:
- Hypertension is closely linked to organ damage and cardiovascular mortality.
- Controlling blood pressure and reversing organ abnormalities may reduce mortality.
- Different antihypertensive drugs with similar effects can yield varying degrees of left ventricular hypertrophy (LVH) regression.
Purpose:
- To explore the relationship between hypertension, organ damage, and cardiovascular mortality.
- To investigate the impact of antihypertensive drugs on LVH regression.
- To evaluate the efficacy of telmisartan and combination therapies (ACE inhibitors and ARBs).
Summary:
- Telmisartan demonstrates LVH regression capabilities even in non-hypotensive doses.
- Combination therapy with ACE inhibitors and ARBs shows theoretical advantages and positive clinical data, though further clarification is needed.
- The ONTARGET study is expected to provide significant insights into these areas.
Impact:
- Understanding drug-specific effects on organ damage is crucial for reducing cardiovascular mortality.
- Telmisartan offers a potential therapeutic option for LVH management.
- Further research, including the ONTARGET study, will refine treatment strategies for hypertension and its complications.
Abstract:
There is close relationship between hypertension, organ damage and cardiovascular mortality. The control of hypertension or the regression of organ abnormalities can cause reduction in mortality but this is to be proven by each drug. Similar degree of antihypertensive effect with different type og drugs can result in different amount of regression of left ventricular hypertrophy. Telmisartan can cause reduction of LVH even in small, non-hypotensive doses. Combination of ACE inhibitors and ARB has a lot of theoretical advantage, the available clinical data are positive however some conflicting data are to be clarified yet. The ongoing ONTARGET study will give answers to a lot of this questions in 4 years.