Antihypertensive, cardiovascular, and pleiotropic effects of angiotensin-receptor blockers.
OBJECTIVE
To review the antihypertensive, cardiovascular and pleiotropic effects of angiotensin-receptor blockers (ARBs).


RESULTS
ARBs are the most recently approved class of antihypertensive agents. They selectively block the angiotensin II type 1 receptor, thus inhibiting most of the deleterious effects of angiotensin II. In addition to blood-pressure control, other benefits may be gained using ARBs. This is because the renin-angiotensin system plays a crucial role in circulatory homoeostasis, and in patients with atherosclerosis, diabetes or hypertension, angiotensin II contributes to the pathophysiology of disease. Evidence-based medicine includes well-controlled studies with mortality and morbidity endpoints in patients with a variety of conditions including hypertension, type 2 diabetes, stroke, renal disease, heart failure, left-ventricular hypertrophy and coronary heart diseases. In addition to these hard endpoints, it has been shown that treatment with ARBs prevents the development of type 2 diabetes, ameliorates coronary and peripheral vascular endothelial dysfunction and decreases plasma levels of several markers of vascular inflammation.


CONCLUSIONS
ARBs are first-line agents for the treatment of hypertension and cardiovascular diseases. Blocking the renin-angiotensin system with these agents has special advantages due to specific vascular and antiatherosclerotic effects, which contribute to a better cardiovascular and renal protection in patients at risk from or with cardiovascular disease.
Sierra
Cristina
C
Hypertension Unit, Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, 170-Villaroel, 08036 Barcelona, Spain.
de la Sierra
Alejandro
A
D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000494:pharmacology*; D002317:Cardiovascular Agents / Q000494:pharmacology*; D002318:Cardiovascular Diseases / Q000188:drug therapy; D002561:Cerebrovascular Disorders / Q000188:drug therapy; D003327:Coronary Disease / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy; D007674:Kidney Diseases / Q000188:drug therapy
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D002317:Cardiovascular Agents