Katsiki Niki, Tsioufis Konstantinos, Ural Dilek, Volpe Massimo
Second Propedeutic Department of Internal Medicine, Hippokration University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
J Clin Hypertens (Greenwich). 2018 Jun 15;20(8):1153-9. doi: 10.1111/jch.13325.
There is an unmet need to prevent cardiovascular disease and chronic kidney disease development and progression worldwide. Losartan, the first angiotensin receptor blocker, was shown to exert significant cardioprotective and renoprotective effects in the LIFE (Losartan Intervention for Endpoint Reduction in Hypertension) and RENAAL (Reduction of Endpoints in NIDDM With the Angiotensin II Antagonist Losartan) trials. Losartan significantly prevented stroke and decreased serum uric acid levels and the rates of new-onset diabetes mellitus and atrial fibrillation. The present review discusses the LIFE (and its subanalyses) and RENAAL trials and the translation of their results to clinical practice. The place of losartan in the current guidelines for hypertension management is also discussed. Losartan still represents an efficacious, safe, and cost-effective therapeutic option in patients with hypertension who have left ventricular hypertrophy. Losartan is a useful antihypertensive agent for stroke prevention and in the management of patients with chronic kidney disease, atrial fibrillation, diabetes mellitus, albuminuria, and hyperuricemia.
在全球范围内，预防心血管疾病和慢性肾脏病的发生与进展存在尚未满足的需求。氯沙坦作为首个血管紧张素受体阻滞剂，在LIFE（氯沙坦干预降低高血压终点事件）和RENAAL（氯沙坦降低非胰岛素依赖型糖尿病终点事件）试验中显示出显著的心脏保护和肾脏保护作用。氯沙坦显著预防了中风，降低了血清尿酸水平以及新发糖尿病和心房颤动的发生率。本综述讨论了LIFE（及其亚分析）和RENAAL试验，以及将其结果转化为临床实践的情况。还讨论了氯沙坦在当前高血压管理指南中的地位。对于有左心室肥厚的高血压患者，氯沙坦仍然是一种有效、安全且具有成本效益的治疗选择。氯沙坦是预防中风以及治疗慢性肾脏病、心房颤动、糖尿病、蛋白尿和高尿酸血症患者的有用降压药物。
