Burnier M, Brunner H R
Division of Hypertension and Vascular Medicine, Lausanne, Switzerland.
J Am Soc Nephrol. 1999 Apr;10 Suppl 12:S278-82.
Blockade of the renin-angiotensin system is recognized as an effective approach for the treatment of hypertension and congestive heart failure. It is possible to antagonize the effects of angiotensin II (AngII) by blocking its receptors, using nonpeptide receptor antagonists. Six angiotensin receptor blockers (ARB) have been approved for the treatment of hypertension: losartan, valsartan, irbesartan, candesartan, telmisartan, and eprosartan. These new drugs are highly selective for the AT1 receptor subtype and induce dose-dependent inhibition of the BP response to exogenous AngII. Numerous double-blind, placebo-controlled studies have demonstrated that ARB are efficacious for treating mild, moderate, and severe hypertension. When compared with other classes of antihypertensive agents, ARB are as effective as angiotensin-converting enzyme inhibitors, calcium antagonists, thiazide diuretics, and beta-blockers. One advantage of ARB as a class is their excellent tolerability and side effect profile. Several large clinical trials of ARB are now under way to demonstrate their benefits in hypertension, heart failure, and type II diabetic nephropathy.
肾素-血管紧张素系统的阻断被认为是治疗高血压和充血性心力衰竭的有效方法。使用非肽类受体拮抗剂阻断血管紧张素II（AngII）的受体，有可能拮抗其作用。六种血管紧张素受体阻滞剂（ARB）已被批准用于治疗高血压：氯沙坦、缬沙坦、厄贝沙坦、坎地沙坦、替米沙坦和依普罗沙坦。这些新药对AT1受体亚型具有高度选择性，并能剂量依赖性地抑制血压对外源性AngII的反应。大量双盲、安慰剂对照研究表明，ARB对治疗轻度、中度和重度高血压有效。与其他类别的抗高血压药物相比，ARB与血管紧张素转换酶抑制剂、钙拮抗剂、噻嗪类利尿剂和β受体阻滞剂一样有效。ARB作为一类药物的一个优点是其出色的耐受性和副作用情况。目前正在进行几项ARB的大型临床试验，以证明它们在高血压、心力衰竭和II型糖尿病肾病方面的益处。
