Lanier Gregg, Sankholkar Kedar, Aronow Wilbert S
Department of Medicine, Division of Cardiology, New York Medical College, Valhalla, NY.
Am J Ther. 2014 Sep-Oct;21(5):419-35. doi: 10.1097/MJT.0b013e31824a0ed7.
Health care providers managing hypertension (HTN) have a large selection of pharmacologic agents to choose from, including several different classes of drugs and many similar drugs within each class. Antagonism of the renin-angiotensin-aldosterone system has been shown to be very effective for HTN, especially in patients with cardiovascular disease, diabetes, and heart failure. Within this group, there have been 2 new agents recently introduced to the US market and approved by the Food and Drug Administration. It is important for the HTN specialist to be familiar with the merits of these 2 drugs: the angiotensin receptor blocker Edarbi (azilsartan) and the renin inhibitor Tekturna (aliskiren). Additionally, there have been several new, fixed-dose combination antihypertensives introduced to the market since 2006 that use a renin-angiotensin-aldosterone antagonist. Seven of these combine 2 drugs together in a single pill: Edarbyclor (azilsartan/chlorthalidone), Exforge (amlodipine/valsartan), Azor (olmesartan/amlodipine), Twynsta (amlodipine/telmisartan), Tekturna HCT [aliskiren/hydrochlorothiazide (HCTZ)], Valturna (aliskiren/valsartan), Tekamlo (aliskiren/amlodipine). Three triple-drug combination medications have also been introduced recently: Exforge HCT (amlodipine/valsartan/HCTZ), Tribenzor (olmesartan/amlodipine/HCTZ), and Amturnide (aliskiren/amlodipine/hydrocholorothiazide). This review will summarize the trial data and important pharmacologic merits of these 2 new renin-angiotensin-aldosterone antagonists and the advantages of initiating treatment with one of the new fixed-dose, combination drugs approved over the last 5 years.
治疗高血压（HTN）的医护人员有大量的药物可供选择，包括几种不同类型的药物，且每类药物中都有许多相似的药物。肾素-血管紧张素-醛固酮系统的拮抗作用已被证明对高血压非常有效，尤其是对患有心血管疾病、糖尿病和心力衰竭的患者。在这一类药物中，最近有2种新药被引入美国市场并获得了美国食品药品监督管理局的批准。高血压专科医生熟悉这2种药物的优点很重要：血管紧张素受体阻滞剂Edarbi（阿齐沙坦）和肾素抑制剂Tekturna（阿利吉仑）。此外，自2006年以来，市场上还推出了几种新型的固定剂量复方抗高血压药物，它们使用了肾素-血管紧张素-醛固酮拮抗剂。其中7种将2种药物组合在一片药中：Edarbyclor（阿齐沙坦/氯噻酮）、Exforge（氨氯地平/缬沙坦）、Azor（奥美沙坦/氨氯地平）、Twynsta（氨氯地平/替米沙坦）、Tekturna HCT[阿利吉仑/氢氯噻嗪（HCTZ）]、Valturna（阿利吉仑/缬沙坦）、Tekamlo（阿利吉仑/氨氯地平）。最近还推出了3种三联药物组合：Exforge HCT（氨氯地平/缬沙坦/HCTZ）、Tribenzor（奥美沙坦/氨氯地平/HCTZ）和Amturnide（阿利吉仑/氨氯地平/氢氯噻嗪）。本综述将总结这2种新型肾素-血管紧张素-醛固酮拮抗剂的试验数据和重要药理学优点，以及使用过去5年中批准的新型固定剂量复方药物之一开始治疗的优势。
