Angiotensin II receptor antagonist

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Angiotensin II receptor antagonists, also called Angiotensin II Type 1 receptor blockers ('ARBs) are "agents that antagonize angiotensin II type 1 receptor. Included are angiotensin II analogs such as saralasin and biphenylimidazoles such as losartan. Some are used as antihypertensive agents."[1]

Mechanism of action

Angiotensin II receptor antagonists block angiotensin II AT1 receptors, in contrast to angiotensin-converting enzyme inhibitors, which block the conversion of angiotensin I to the hypertensive angiotensin II. Along with Angiotensin-converting enzyme inhibitors. Randomized controlled trials have investigated the use of the two classes together for a synergistic effect, but have found increased adverse effects with no added benefit from their combination.[2]

Applications

These drugs are primarily antihypertensives. They may also be used to protect the kidneys.

Adverse effects

Angiotensin II receptor antagonists can cause hyperkalemia. The rise in potassium has been reported to be both similar to[3] and less that occurs with angiotensin-converting enzyme inhibitors.[4] A newer factorial randomized controlled trial has compared these drugs.[5]

References

  1. Anonymous (2024), Angiotensin II Type 1 Receptor Blockers (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. McMurray JJ (April 2008). "ACE inhibitors in cardiovascular disease--unbeatable?". N. Engl. J. Med. 358 (15): 1615–6. DOI:10.1056/NEJMe0801925. PMID 18378521. Research Blogging.
  3. The ONTARGET Investigators. 2008. Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events. N Engl J Med 358, no. 15:1547-1559.
  4. Bakris GL, Siomos M, Richardson D, et al (2000). "ACE inhibition or angiotensin receptor blockade: impact on potassium in renal failure. VAL-K Study Group". Kidney Int. 58 (5): 2084–92. DOI:10.1111/j.1523-1755.2000.00381.x. PMID 11044229. Research Blogging.
  5. Mann et al. 2008. Lancet Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial