Candesartan for the treatment of hypertension and heart failure.
Candesartan is a selective angiotensin II Type I (AT(1)) receptor blocker which binds tightly to, and dissociates slowly from the receptor. It is an effective, long-acting antihypertensive agent with few or no side effects, when compared to placebo in hypertension trials. Several studies indicate that candesartan might prevent diabetes. A research programme of three prospective randomised outcome trials (the CHARM [Candesartan in Heart Failure Assessment of Reduction in Mortality and Morbidity] programme) has shown that candesartan is of clinical value in a broad spectrum of patients with symptomatic heart failure, regardless of background therapy and ventricular function. There is a clear benefit of candesartan in patients unable to tolerate an angiotensin-converting enzyme inhibitor (ACEI) and this benefit is of a similar magnitude to that obtained with an ACEI. CHARM-Added shows that symptoms, morbidity and cardiovascular mortality are further reduced if an AT(1)-receptor blocker is added to an ACEI. This benefit is not only statistically significant but also clinically important. CHARM-Preserved indicate that candesartan can reduce hospital admission for heart failure in patients with preserved systolic function.
Ostergren
Jan
J
Karolinska University Hospital, Department of Medicine, Solna, 171 76 Stockholm, Sweden. jan.ostergren@kus.se
D000284:Administration, Oral; D001562:Benzimidazoles / Q000378:metabolism / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D013777:Tetrazoles / Q000378:metabolism / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014018:Tissue Distribution; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C077793:candesartan cilexetil; C081643:candesartan