Ribeiro Artur Beltrame, Gavras Haralambos
Nephrology Division, Hospital do Rim e Hipertensão, Fundação Oswaldo Ramos, UNIFESP, São Paulo, SP, Brazil.
Arq Bras Endocrinol Metabol. 2006 Apr;50(2):327-33. doi: 10.1590/s0004-27302006000200019. Epub 2006 May 23.
Angiotensin II antagonists (AIIAs) were introduced to treat hypertension about 10 years ago. During this period they were evaluated not only in terms of efficacy and safety but also in several large studies with clinical outcomes. They are efficacious in all clinical forms of hypertension and are effective also in all ethnic groups. Cardiovascular and renal protection in proteinuric diabetic nephropathy beyond blood pressure reduction was proved in major clinical studies: Losartan Intervention For Endpoint reduction in hypertension study (LIFE), Reduction of Endpoint in Non-Insulin dependent Diabetes Mellitus with the AII Antagonist Losartan (RENAAL) and Irbesartan Type 2 Diabetic Nephropathy Trial (IDNT). Their blood pressure independent protective effect is also mentioned by the blockade of AT1 receptor. As a class AIIs have a tolerability profile similar to placebo.
大约10年前，血管紧张素II拮抗剂（AIIAs）被用于治疗高血压。在此期间，人们不仅对其疗效和安全性进行了评估，还在多项涉及临床结局的大型研究中对其进行了评估。它们对所有临床类型的高血压均有效，对所有种族群体也均有效果。主要临床研究证实，在蛋白尿性糖尿病肾病中，血管紧张素II拮抗剂除了能降低血压外，还具有心血管和肾脏保护作用：氯沙坦干预降低高血压终点研究（LIFE）、血管紧张素II拮抗剂氯沙坦降低非胰岛素依赖型糖尿病终点研究（RENAAL）以及厄贝沙坦2型糖尿病肾病试验（IDNT）。AT1受体的阻断也提到了它们不依赖血压的保护作用。作为一类药物，血管紧张素II拮抗剂的耐受性与安慰剂相似。
