Akhrass Philippe R, McFarlane Samy I
State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
Vasc Health Risk Manag. 2011;7:677-83. doi: 10.2147/VHRM.S9447. Epub 2011 Nov 15.
Cardiovascular risk reduction has been the target of several large clinical trials in the last decade. As the activation of the renin-angiotensin-aldosterone system (RAAS) plays a central role in the pathogenesis of atherosclerosis and cardiovascular disease, RAAS blockade has been suggested to be among the most efficient cardioprotective interventions, as revealed with the angiotensin converting enzyme (ACE) inhibitors trials. The angiotensin receptor blockers' (ARBs) efficacy in lowering blood pressure has been very well established. Telmisartan is however the first ARB to show a promising role in reducing cardiovascular risk in high-risk patients. This article will highlight the role of telmisartan in cardioprotection, underlying specifically the results of two major randomized controlled trials: ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomized AssessmeNt Study in aCE-iNtolerant subjects with cardiovascular Disease).
在过去十年中,降低心血管风险一直是多项大型临床试验的目标。由于肾素-血管紧张素-醛固酮系统(RAAS)的激活在动脉粥样硬化和心血管疾病的发病机制中起着核心作用,正如血管紧张素转换酶(ACE)抑制剂试验所揭示的那样,RAAS阻断被认为是最有效的心脏保护干预措施之一。血管紧张素受体阻滞剂(ARB)在降低血压方面的疗效已经得到了充分证实。然而,替米沙坦是首个在高危患者中显示出降低心血管风险的有前景作用的ARB。本文将重点介绍替米沙坦在心脏保护中的作用,特别强调两项主要随机对照试验的结果:ONTARGET(替米沙坦单药及与雷米普利联合应用的全球终点试验)和TRANSCEND(替米沙坦在不耐受ACE抑制剂的心血管疾病患者中的随机评估研究)。