title: Vascular and metabolic effects of angiotensin II receptor blockers.
abstract: Angiotensin II receptor blockers (ARBs) are widely used in patients with hypertension, heart failure and type 2 diabetes mellitus (T2DM). Several large clinical trials have demonstrated that these agents are effective in reducing cardiovascular mortality and morbidity. These benefits are partly independent of the degree of blood pressure reduction and most likely related to ARBs' anti-inflammatory, metabolic and vascular effects. Clinical studies showed that the anti-inflammatory effect of ARBs could be related to the dosage and/or the length of the treatment. In large clinical trials, ARBs have inconsistently reduced the risk of new-onset T2DM. Among ARBs, only losartan significantly reduced serum uric acid levels. Moreover, it has been demonstrated that ARBs improve endothelial dysfunction in patients with hypertension and/or coronary artery disease (CAD), while all but one of the studies proved that these agents could usually, after 6-12 months of therapy, induce regression of vascular hypertrophy in hypertensive patients. These positive effects could be relevant to vascular protection and, together with the blood pressure reduction, constitute the background of the improved outcome observed in clinical studies on mortality and/or morbidity in hypertensive, high-risk and CAD patients. The clinical significance of the different potency of ARBs needs to be investigated further in specific and adequately powered trials.
authors.affiliation: Antonio Cardarelli Hospital, Cardiology Unit, 9, Via Antonio Cardarelli, 80131 Napoli, Naples, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Barra
authors.forename: Alice
authors.initials: A
authors.lastname: Vitagliano
authors.forename: Vittoria
authors.initials: V
authors.lastname: Cuomo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Vitagliano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gaeta
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism; D016893:Carotid Stenosis / Q000188:drug therapy / Q000378:metabolism; D003327:Coronary Disease / Q000188:drug therapy / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000378:metabolism; D007249:Inflammation / Q000378:metabolism / Q000517:prevention & control
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers