McClellan K J, Markham A
Adis International Limited, Auckland, New Zealand.
Drugs. 1998 Dec;56(6):1039-44; discussion 1045-6. doi: 10.2165/00003495-199856060-00007.
Telmisartan is a nonpeptide angiotensin II receptor antagonist which selectively and insurmountably inhibits the angiotensin II AT1 receptor subtype without affecting other receptor systems involved in cardiovascular regulation. Oral telmisartan dose-dependently reduced blood pressure (BP) in various animal models of hypertension. In transgenic rats, telmisartan reduced cardiac hypertrophy and glomerulosclerosis. When administered at dosages of 40 to 160 mg once daily to patients with mild to moderate hypertension, telmisartan significantly reduced systolic and diastolic BP compared with placebo and was at least as effective as atenolol 50 or 100 mg and lisinopril 10 to 40 mg. One study showed telmisartan 80 mg/day to be more effective than enalapril 20 mg/day. In 2 studies that used ambulatory BP monitoring, once daily telmisartan provided better control of diastolic BP for the full dosing interval than losartan potassium 50 mg or amlodipine 5 or 10 mg. In a single study in patients with severe hypertension, a telmisartan-based regimen had antihypertensive efficacy similar to that of an enalapril-based regimen. Telmisartan had a tolerability profile similar to that of placebo in clinical studies.
替米沙坦是一种非肽类血管紧张素II受体拮抗剂,可选择性且不可逆地抑制血管紧张素II的AT1受体亚型,而不影响参与心血管调节的其他受体系统。口服替米沙坦可使各种高血压动物模型的血压剂量依赖性降低。在转基因大鼠中,替米沙坦可减轻心脏肥大和肾小球硬化。对于轻至中度高血压患者,每日一次给予40至160mg的替米沙坦,与安慰剂相比,可显著降低收缩压和舒张压,且疗效至少与50或100mg阿替洛尔及10至40mg赖诺普利相当。一项研究表明,每日80mg替米沙坦比每日20mg依那普利更有效。在2项使用动态血压监测的研究中,每日一次服用替米沙坦在整个给药间隔期对舒张压的控制优于50mg氯沙坦钾或5或10mg氨氯地平。在一项针对重度高血压患者的单一研究中,基于替米沙坦的治疗方案的降压疗效与基于依那普利的治疗方案相似。在临床研究中,替米沙坦的耐受性与安慰剂相似。