azilsartan and Cardiovascular-Diseases

We have reviewed the effects of angiotensin II type 1 receptor antagonists (ARBs) in various animal models of hypertension, atherosclerosis, cardiac function, hypertrophy and fibrosis, glucose and lipid metabolism, and renal function and morphology. Those of azilsartan and telmisartan have been included comprehensively whereas those of other ARBs have been included systematically but without intention of completeness. ARBs as a class lower blood pressure in established hypertension and prevent hypertension development in all applicable animal models except those with a markedly suppressed renin-angiotensin system; blood pressure lowering even persists for a considerable time after discontinuation of treatment. This translates into a reduced mortality, particularly in models exhibiting marked hypertension. The retrieved data on vascular, cardiac and renal function and morphology as well as on glucose and lipid metabolism are discussed to address three main questions: 1. Can ARB effects on blood vessels, heart, kidney and metabolic function be explained by blood pressure lowering alone or are they additionally directly related to blockade of the renin-angiotensin system? 2. Are they shared by other inhibitors of the renin-angiotensin system, e.g. angiotensin converting enzyme inhibitors? 3. Are some effects specific for one or more compounds within the ARB class? Taken together these data profile ARBs as a drug class with unique properties that have beneficial effects far beyond those on blood pressure reduction and, in some cases distinct from those of angiotensin converting enzyme inhibitors. The clinical relevance of angiotensin receptor-independent effects of some ARBs remains to be determined.

Topics: Angiotensin II Type 1 Receptor Blockers; Animals; Animals, Genetically Modified; Antihypertensive Agents; Atherosclerosis; Benzimidazoles; Benzoates; Blood Pressure; Cardiovascular Diseases; Culture Techniques; Disease Models, Animal; Drug Therapy, Combination; Endothelium, Vascular; Gene Knockout Techniques; Glucose; Humans; Hypertension; Kidney; Lipid Metabolism; Metabolic Diseases; Oxadiazoles; Renin-Angiotensin System; Stroke; Telmisartan

The CV-CARE registry provides RWE in Canadian routine clinical practice.. In a real-world Canadian setting, MetER, C, AZI, AZI/CHL, and TXC show improvement of the cardiometabolic profile of T2D, HCh, and HTN patients.

Topics: Aged; Anticholesteremic Agents; Antihypertensive Agents; Benzimidazoles; Canada; Cardiovascular Diseases; Chlorthalidone; Colesevelam Hydrochloride; Diabetes Mellitus, Type 2; Female; Humans; Hypercholesterolemia; Hypertension; Hypoglycemic Agents; Male; Metabolic Syndrome; Metformin; Middle Aged; Oxadiazoles; Prospective Studies; Registries; Treatment Outcome

Advantages of the new angiotensin receptor blockers (ARBs) include once daily dosing, an absence of significant adverse reactions, well tolerated side effect profile and cost effectiveness. A growing realization is their beneficial pleotropic effects. Antihypertensive agents are widely used to reduce the risk of cardiovascular events partly beyond that of blood pressure-lowering. The RAAS, and its primary mediator Ang II, also have a direct influence on the progression of the atherosclerotic process via effects on endothelial function, inflammation, fibrinolytic balance, and plaque stability. For patients at high cardiovascular risk based on the results of the ONTARGET and TRANSCEND studies, telmisartan is indicated for cardiovascular prevention. Studies have shown that olmesartan medoxomil treatment may slow the progression of atherosclerosis and postpone albuminuria thereby potentially improving CV outcomes.

Topics: Albuminuria; Angiotensin II Type 1 Receptor Blockers; Atherosclerosis; Benzimidazoles; Benzoates; Cardiovascular Diseases; Humans; Hypertension; Imidazoles; Olmesartan Medoxomil; Oxadiazoles; Telmisartan; Tetrazoles; Treatment Outcome