Baker William L, Nigro Stefanie C, White William B
University of Connecticut, School of Pharmacy, Storrs, CT, USA.
Expert Rev Cardiovasc Ther. 2014 Jul;12(7):791-8. doi: 10.1586/14779072.2014.924853. Epub 2014 Jun 2.
Azilsartan medoxomil (AZL) is the most recently approved angiotensin receptor blocker (ARB) for treating patients with hypertension. A fixed-dose combination product with AZL and the thiazide-like diuretic chlorthalidone (CLD) is now available to treat individuals who require additional blood pressure lowering. For this review, a literature search was conducted using MEDLINE and the keywords and MeSH terms azilsartan, azilsartan medoxomil, chlorthalidone, thiazide, blood pressure and hypertension. References for retrieved articles were also scanned for relevant citations. No language restrictions were used. AZL is structurally related to candesartan and has been shown to provide more potent angiotensin receptor antagonism versus other ARBs. CLD is a thiazide-like diuretic with a longer half-life and greater blood pressure lowering efficacy than hydrochlorothiazide. The combination of AZL plus CLD has superior efficacy to other ARBs alone or in combination with hydrochlorothiazide based on extensive evaluation in clinical trials. This superior efficacy is not offset by a large imbalance in clinically important adverse events.
阿齐沙坦美洛昔酯(AZL)是最近被批准用于治疗高血压患者的血管紧张素受体阻滞剂(ARB)。一种含有AZL和噻嗪类利尿剂氯噻酮(CLD)的固定剂量复方制剂现已上市,用于治疗需要进一步降低血压的患者。在本次综述中,使用MEDLINE以及关键词和医学主题词阿齐沙坦、阿齐沙坦美洛昔酯、氯噻酮、噻嗪类、血压和高血压进行了文献检索。对检索到的文章的参考文献也进行了扫描以查找相关引用。未设置语言限制。AZL在结构上与坎地沙坦相关,并且已证明与其他ARB相比,它能提供更强效的血管紧张素受体拮抗作用。CLD是一种噻嗪类利尿剂,其半衰期比氢氯噻嗪更长,降压效果也更强。基于在临床试验中的广泛评估,AZL加CLD的组合比单独使用其他ARB或与氢氯噻嗪联合使用具有更优的疗效。这种更优的疗效并未被临床重要不良事件的巨大失衡所抵消。