Angiotensin II antagonists: clinical experience in the treatment of hypertension, prevention of cardiovascular outcomes and renal protection in diabetic nephropathy and proteinuria

Angiotensin II antagonists: clinical experience in the treatment of hypertension, prevention of cardiovascular outcomes and renal protection in diabetic nephropathy and proteinuria

Alternative title Antagonistas da angiotensina II: experiência clínica com o tratamento da hipertensão, prevenção de desfechos cardiovasculares e proteção renal na nefropatia diabética e proteinúria
Author Ribeiro, Artur Beltrame Autor UNIFESP Google Scholar
Gavras, Haralambos Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
University School of Medicine Hypertension and Atherosclerosis Section
Abstract Angiotensin II antagonists (AIIAs) were introduced to treat hypertension about 10 years ago. During this period they were evaluated not only in terms of efficacy and safety but also in several large studies with clinical outcomes. They are efficacious in all clinical forms of hypertension and are effective also in all ethnic groups. Cardiovascular and renal protection in proteinuric diabetic nephropathy beyond blood pressure reduction was proved in major clinical studies: Losartan Intervention For Endpoint reduction in hypertension study (LIFE), Reduction of Endpoint in Non-Insulin dependent Diabetes Mellitus with the AII Antagonist Losartan (RENAAL) and Irbesartan Type 2 Diabetic Nephropathy Trial (IDNT). Their blood pressure independent protective effect is also mentioned by the blockade of AT1 receptor. As a class AIIs have a tolerability profile similar to placebo.

Os antagonistas da angiotensina II (AAIIs) foram introduzidos para o tratamento da hipertensão arterial há cerca de 10 anos. Durante esse período eles foram avaliados não apenas em termos de eficácia e segurança, mas também em vários estudos grandes com desfechos clínicos. Os AAIIs são eficazes em todas as formas clínicas de hipertensão e, também, em todos os grupos étnicos. Os principais estudos clínicos em pacientes diabéticos com nefropatia e proteinúia comprovaram, além da redução da pressão arterial, proteção cardiovascular e renal: Losartan Intervention For Endpoint reduction in hypertension study (LIFE), Reduction of Endpoint in Non-Insulin dependent Diabetes Mellitus with the AII Antagonist Losartan (RENAAL) e Irbesartan Type 2 Diabetic Nephropathy Trial (IDNT). O seu efeito protetor independente da pressão sanguínea também é mencionado pelo bloqueio do receptor AT1. Os AAIIs, como classe medicamentosa, apresentam um perfil de tolerabilidade semelhante ao placebo.
Keywords Hypertension
Cardiovascular disease
Diabetes mellitus
Angiotensin II antagonists
Stroke
End-stage renal disease
Losartan
Hipertensão
Doença cardiovascular
Diabetes mellitus
Antagonistas de angiotensina II
Acidente vascular cerebral
Doença renal terminal
Losartana
Language English
Date 2006-04-01
Published in Arquivos Brasileiros de Endocrinologia & Metabologia. Sociedade Brasileira de Endocrinologia e Metabologia, v. 50, n. 2, p. 327-333, 2006.
ISSN 0004-2730 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Endocrinologia e Metabologia
Extent 327-333
Origin http://dx.doi.org/10.1590/S0004-27302006000200019
Access rights Open access Open Access
Type Article
SciELO ID S0004-27302006000200019 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/3028

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