Man in't Veld A J
Department of Internal Medicine, Academisch Ziekenhuis Dijkzigt, Rotterdam, The Netherlands.
J Hypertens Suppl. 1997 Dec;15(7):S27-33.
The clinical management of hypertension has traditionally been hampered by a limited therapeutic window, which has resulted in the maintenance of patients on doses of antihypertensive agents that often produce clinically significant side effects and suboptimal blood pressure control. To expand this window, a therapeutic agent must provide optimal, dose-related blood pressure control with placebo-like tolerability.
Irbesartan, a new angiotensin II receptor antagonist, has been shown to provide significant blood pressure reductions compared with placebo and equal or better reductions compared with major antihypertensive agents of other classes. These effects have been demonstrated in an extensive clinical trials program, comprising 1691 irbesartan-treated patients and 539 placebo-treated patients. Active-drug-controlled trials with beta-blockers, angiotensin converting enzyme inhibitors, calcium antagonists and diuretics have further confirmed the excellent results with irbesartan. Moreover, irbesartan demonstrates a clear dose-related therapeutic response with no dose-related effects on adverse event rates.
The clear advantages of irbesartan over antihypertensive agents of other classes have the potential to expand the therapeutic window in the treatment of hypertension, thus improving the chances that a majority of patients will attain long-term blood pressure control with freedom from side effects.
传统上，高血压的临床管理受到治疗窗有限的阻碍，这导致患者维持使用的抗高血压药物剂量常常会产生具有临床意义的副作用，且血压控制效果欠佳。为了扩大这一治疗窗，一种治疗药物必须能提供与剂量相关的最佳血压控制效果，同时具备类似安慰剂的耐受性。
厄贝沙坦是一种新型血管紧张素II受体拮抗剂，与安慰剂相比，它已被证明能显著降低血压，与其他类别的主要抗高血压药物相比，血压降低幅度相同或更大。这些效果已在一项广泛的临床试验项目中得到证实，该项目包括1691例接受厄贝沙坦治疗的患者和539例接受安慰剂治疗的患者。与β受体阻滞剂、血管紧张素转换酶抑制剂、钙拮抗剂和利尿剂进行的活性药物对照试验进一步证实了厄贝沙坦的优异效果。此外，厄贝沙坦显示出明确的剂量相关治疗反应，且对不良事件发生率无剂量相关影响。
厄贝沙坦相对于其他类别的抗高血压药物具有明显优势，有可能扩大高血压治疗的治疗窗，从而提高大多数患者实现长期血压控制且无副作用的几率。
