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The place of ARBs inheart failuretherapy: isaldosteronesuppression the key? Uma MarkanSamhitha PasupuletiCelina M. Pollard2019 год

The place of ARBs in heart failure therapy: is aldosterone suppression the key?
review

Полный текстСтраница публикацииПубликация в OpenAlex
Аннотация: Since the launch of the first orally available angiotensin II (AngII) type 1 receptor (AT 1 R) blocker (ARB) losartan (Cozaar) in the late 1990s, the class of ARBs (or ‘sartans’, short for Angiotensin-RecepTor-ANtagonistS) quickly expanded to include candesartan, eprosartan, irbesartan, valsartan, telmisartan, and olmesartan. All ARBs have high affinity for the AT 1 receptor, expressed in various tissues, including smooth muscle cells, heart, kidney, and brain. Since activation of AT 1 R, the target of these drugs, leads, among other effects, to vascular smooth muscle cell growth, proliferation and contraction, activation of fibroblasts, cardiac hypertrophy, aldosterone secretion from the adrenal cortex, thirst-fluid intake (hypervolemia), etc., the ARBs are nowadays one of the most useful cardiovascular drug classes used in clinical practice. However, significant differences in their pharmacological and clinical properties exist that may favor use of particular agents over others within the class, and, in fact, two of these drugs, candesartan and valsartan, continuously appear to distinguish themselves from the rest of the ‘pack’ in recent clinical trials. The reason(s) for the potential superiority of these two agents within the ARB class are currently unclear but under intense investigation. The present short review gives an overview of the clinical properties of the ARBs currently approved by the United States Food and Drug Administration, with a particular focus on candesartan and valsartan and the areas where these two drugs seem to have a therapeutic edge. In the second part of our review, we outline recent data from our laboratory (mainly) on the molecular effects of the ARB drugs on aldosterone production and on circulating aldosterone levels, which may underlie (at least in part) the apparent clinical superiority of candesartan (and valsartan) over most other ARBs currently in clinical use.
Год издания: 2019
Авторы: Uma Markan, Samhitha Pasupuleti, Celina M. Pollard, Arianna Perez, Beatrix Aukszi, Anastasios Lymperopoulos
Издательство: SAGE Publishing
Источник: Therapeutic Advances in Cardiovascular Disease
Ключевые слова: Heart Failure Treatment and Management, Hormonal Regulation and Hypertension, Blood Pressure and Hypertension Studies
Другие ссылки: Therapeutic Advances in Cardiovascular Disease (PDF)
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DOAJ (DOAJ: Directory of Open Access Journals) (HTML)
Europe PMC (PubMed Central) (PDF)
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NSUWorks (Nova Southeastern University) (PDF)
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PubMed Central (HTML)
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