Potential renoprotective effects of the angiotensin receptor blocker eprosartan: a review of preliminary renal studies.
The importance of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of hypertension and in renal disease, particularly in patients with diabetes, has become increasingly evident. Pharmacological blockade of the RAAS offers potential for the therapeutic management of these pathologies. Angiotensin converting enzyme (ACE) inhibitors and angiotensin II (AII) receptor blockers have been shown to exhibit effectiveness in the treatment of hypertension. AII receptor blockers have a renal protective effect owing to their ability to reduce systemic blood and intraglomerular pressures. Eprosartan is a chemically distinct AII blocker, which displays a dual mode of action whereby it blocks both pre- and postsynaptic AT(1) receptors, potentially benefiting patients with hypertension and renal disease. In addition, evidence suggests that eprosartan is well tolerated by both healthy subjects and patients with varying degree of renal impairment, such that the dose does not need to be modified in patients with mild to moderate renal impairment. Results from preliminary studies demonstrates that eprosartan doses will below those required for blood pressure control have a pronounced effect on the kidney and do not compromise renal autoregulatory mechanisms. Therefore, eprosartan may have a benefit in the prevention or delay of renal damage in hypertensive patients with renal impairment, although this remains to be determined in a clinical setting.
Divisions of Hypertension and Nephrology, Groote Schuur Hospital, Cape Town, South Africa.
B
B
Rayner
B
B
Jaeger
C N
CN
Verboom
M
M
Pascoe
D000179:Acrylates / Q000627:therapeutic use*; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007093:Imidazoles / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007674:Kidney Diseases / Q000517:prevention & control*; D044140:Receptor, Angiotensin, Type 1 / Q000627:therapeutic use*; D012084:Renin-Angiotensin System / Q000187:drug effects; D012720:Severity of Illness Index; D013876:Thiophenes / Q000627:therapeutic use*
D000179:Acrylates; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D007093:Imidazoles; D044140:Receptor, Angiotensin, Type 1; D013876:Thiophenes; C068373:eprosartan