Andersen R S, Christensen S
Københavns Universitet, Farmakologisk Institut.
Ugeskr Laeger. 2001 Dec 10;163(50):7036-9.
Blockade of the renin-angiotensin system has proved an important principle in the pharmacotherapy of cardiovascular diseases. There is now overwhelming documentation on the beneficial effect of angiotensin converting enzyme inhibitors (ACE inhibitors) on mortality and morbidity in patients with cardiovascular risk factors. Such documentation is still lacking for the angiotensin II receptor antagonists which, in 1999, sold for 77% of the amount spent on ACE inhibitors in Denmark. This review assesses the therapeutic effects of angiotensin II antagonists compared with the ACE inhibitors in patients with uncomplicated essential hypertension. From 21 comparative studies with a duration of up to one year, it can be concluded that the lowering of the blood pressure with the two classes is similar. Both showed relatively few side effects, the only difference being a higher incidence of cough after ACE inhibitors. Until larger comparative long-term studies on mortality and morbidity have been conducted, angiotensin II antagonists should only be used in hypertensive patients experiencing unacceptable side effects with ACE inhibitors.
肾素 - 血管紧张素系统的阻断已被证明是心血管疾病药物治疗中的一项重要原则。目前，关于血管紧张素转换酶抑制剂（ACE抑制剂）对具有心血管危险因素患者的死亡率和发病率的有益作用，已有大量文献记载。而对于血管紧张素II受体拮抗剂，此类文献仍然缺乏，1999年在丹麦，其销售额仅为ACE抑制剂花费金额的77%。本综述评估了血管紧张素II拮抗剂与ACE抑制剂相比，在单纯原发性高血压患者中的治疗效果。从21项持续时间长达一年的比较研究可以得出结论，这两类药物降低血压的效果相似。两者的副作用都相对较少，唯一的区别是ACE抑制剂后咳嗽的发生率较高。在进行更大规模的关于死亡率和发病率的比较长期研究之前，血管紧张素II拮抗剂仅应用于使用ACE抑制剂出现不可接受副作用的高血压患者。
