Rakugi H, Ogihara T
Department of Geriatric Medicine, Osaka University Medical School.
Nihon Rinsho. 1997 Aug;55(8):2075-80.
Nonpeptide angiotensin II type 1-receptor antagonists, AT1 receptor antagonists are newly developed and useful drugs for hypertension and congestive heart failure. In Japan, the efficacy and safety of losartan and candesartan cilexetil in patients with essential hypertension have been evaluated by the double-blind, parallel group-comparison study using enalapril as control drug. Both trials revealed that these drugs showed a hypotensive effect comparable to that of enalapril with a high safety since the adverse drug reaction of cough was recognized in very few patients. Furthermore, a recent randomised trial of losartan versus captopril in patients over 65 with heart failure, evaluation of losartan in the elderly study (ELITE), showed that losartan was associated with a lower mortality than that found with captopril. Further studies will clarify differences in protection of cardiovascular system with a long-term treatment between AT1, receptor antagonists and angiotensin-converting enzyme inhibitors.
非肽类血管紧张素II 1型受体拮抗剂,即AT1受体拮抗剂,是新开发的用于治疗高血压和充血性心力衰竭的有效药物。在日本,通过以依那普利作为对照药物的双盲、平行组比较研究,对氯沙坦和坎地沙坦酯在原发性高血压患者中的疗效和安全性进行了评估。两项试验均显示,这些药物的降压效果与依那普利相当,且安全性高,因为很少有患者出现咳嗽这一药物不良反应。此外,最近一项针对65岁以上心力衰竭患者的氯沙坦与卡托普利的随机试验,即氯沙坦在老年人中的评估研究(ELITE),表明氯沙坦的死亡率低于卡托普利。进一步的研究将阐明AT1受体拮抗剂和血管紧张素转换酶抑制剂在长期治疗中对心血管系统保护作用的差异。