Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy.
Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Adv Ther. 2019 Feb;36(2):278-297. doi: 10.1007/s12325-018-0859-x. Epub 2018 Dec 27.
Blood pressure lowering by all classes of antihypertensive drugs is accompanied by significant reductions of stroke and major cardiovascular (CV) events. Drugs acting on the renin-angiotensin-aldosterone system, such as angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), showed similar benefit on major CV events to other antihypertensive medications. In real-world practice, ARBs reduced by 10% the incidence of CV mortality, non-fatal myocardial infarction, non-fatal stroke and provided superior protection against CV events than ACEIs in high-risk patients. Despite similar antihypertensive properties and a favourable safety profile for both ACEIs and ARBs, evidence indicates that patients treated with ARBs have lower rates of withdrawal for adverse events and greater persistence to therapy than those treated with ACEIs. Among ARBs, olmesartan is one of the latest generation compounds introduced in clinical practice for treating hypertension: head-to-head comparative trials suggest that the efficacy of olmesartan is superior to that of commonly prescribed ACEIs (ramipril and perindopril). The drug, administered as a monotherapy or in combination with a dihydropyridine calcium channel blocker or a thiazide diuretic, has proved to be effective in maintaining blood pressure stability over 24 h, with a favourable safety profile and low discontinuation rates. These properties are pivotal for considering olmesartan as a useful antihypertensive agent especially for high-risk patients (e.g. elderly, diabetics, patients with metabolic syndrome).Funding: Article preparation and open access fee were funded by Menarini International Operations Luxembourg S.A. (M.I.O.L.).
所有类别的降压药物都可降低血压，并显著减少中风和主要心血管（CV）事件。作用于肾素-血管紧张素-醛固酮系统的药物，如血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs），在主要 CV 事件方面与其他降压药物具有相似的益处。在实际实践中，ARBs 可使 CV 死亡率、非致死性心肌梗死、非致死性中风的发生率降低 10%，并为高危患者提供优于 ACEIs 的 CV 事件保护。尽管 ACEIs 和 ARBs 具有相似的降压特性和有利的安全性特征，但有证据表明，与 ACEIs 治疗的患者相比，ARBs 治疗的患者因不良反应而停药的比率较低，对治疗的坚持性更高。在 ARBs 中，奥美沙坦是临床实践中引入的最新一代化合物之一，用于治疗高血压：头对头比较试验表明，奥美沙坦的疗效优于常用的 ACEIs（雷米普利和培哚普利）。该药物作为单一疗法或与二氢吡啶钙通道阻滞剂或噻嗪类利尿剂联合使用，已被证明在维持 24 小时血压稳定方面有效，具有有利的安全性特征和较低的停药率。这些特性对于将奥美沙坦视为一种有用的降压药物，特别是对于高危患者（如老年人、糖尿病患者、代谢综合征患者）非常重要。
本文的准备和开放获取费用由 Menarini International Operations Luxembourg S.A.（M.I.O.L.）资助。
