Related Experiment Videos
Angiotensin II receptor antagonists. Potential in elderly patients with cardiovascular disease
1Department of Medicine, University of Melbourne, Austin and Repatriation Medical Centre, Melbourne, Victoria, Australia. burrell@austin.unimelb.edu.au
Insights
High blood pressure in older adults is a significant risk factor for cardiovascular disease. Antihypertensive medications, including angiotensin II receptor antagonists, effectively manage hypertension and reduce related mortality in the elderly.
Area of Science:
- Gerontology
- Cardiology
- Pharmacology
Background:
- Elevated blood pressure in the elderly is a major risk factor for cardiovascular and cerebrovascular diseases, accounting for over 50% of deaths in individuals over 65.
- The rising elderly population worldwide underscores the critical importance of effective blood pressure management in this demographic.
- Antihypertensive medications have proven efficacy in reducing cardiovascular morbidity and mortality in older adults, with greater absolute benefits compared to younger patients.
Purpose of the Study:
- To evaluate the efficacy and tolerability of angiotensin II (AII) receptor antagonists in treating hypertension in the elderly.
- To compare AII receptor antagonists with existing treatments like ACE inhibitors for hypertension in older individuals.
- To assess the potential role of AII receptor antagonists in managing hypertension-related risks in the aging population.
Main Methods:
- Review of intervention studies demonstrating the benefits of antihypertensive medication in the elderly.
- Analysis of clinical data on the effectiveness and adverse effects of ACE inhibitors and AII receptor antagonists (e.g., losartan, valsartan).
- Examination of current data on AII receptor antagonists for elderly hypertensive patients, noting the need for long-term tolerability and clinical outcomes data.
Main Results:
- ACE inhibitors are effective and well-tolerated treatments for hypertension in the elderly.
- Angiotensin II receptor antagonists, such as losartan, are effective in treating essential hypertension with a low incidence of adverse effects.
- While angioedema is a rare risk with AII receptor antagonists, they are generally well-tolerated, though long-term data are pending.
Conclusions:
- Angiotensin II receptor antagonists show promise as effective treatments for hypertension in elderly patients.
- These agents are currently considered for patients intolerant to ACE inhibitors, with potential for broader use pending further long-term data.
- Continued research into long-term tolerability and clinical outcomes is essential to fully establish the role of AII receptor antagonists in elderly hypertension management.
Abstract:
Raised blood pressure in the elderly is not a normal consequences of aging, but is a major risk factor for cardiovascular disease. Cardiac and cerebrovascular disease account for > 50% of deaths among people aged > 65 years. Because the percentage of elderly people in most populations is rising, blood pressure control in this group is becoming increasingly important. Several large intervention studies in the elderly have demonstrated that antihypertensive medication reduces cardiovascular morbidity and mortality. In addition, the absolute benefits of blood pressure reduction are higher in elderly compared with younger patients. ACE inhibitors are effective and well tolerated in the treatment of hypertension in the elderly. Their success led to interest in alternative ways of blocking the renin angiotensin system, and the subsequent development of angiotensin II (AII) receptor antagonists. Losartan was the first drug in this class to become commercially available. Since then, valsartan has been launched in some markets and others are likely to be launched in the near future. Losartan is effective in the treatment of essential hypertension and has a low incidence of adverse effects. First-dose hypotension is very uncommon and, at the present time, cough does not appear to be an adverse effect of these drugs, although long term tolerability studies are needed to confirm this. Angioedema, a rare but life-threatening adverse effect of ACE inhibitors, has also been associated with losartan. Current data suggest that All receptor antagonists are effective in elderly hypertensive patients, although further data are needed to confirm these findings. At present, All receptor antagonists are likely to be used in hypertensive patients who are intolerant of ACE inhibitors, although this may change with the availability of long term tolerability and clinical outcomes data.