Choosing among renin-angiotensin system blockers for the management of hypertension: from pharmacology to clinical efficacy

Current Medical Research and Opinion
J M Neutel

Abstract

Hypertension is an important healthcare challenge, yet despite initiatives to improve detection and advances in therapy, the majority of patients do not achieve recommended blood pressure targets and remain at high cardiovascular risk. Physicians are confronted with an array of antihypertensive agents, accompanied by increasingly complex and often conflicting evidence regarding their efficacy and tolerability. An extensive PubMed and Cochrane database search was conducted to identify clinical literature (published 1990-2009) on the blood pressure lowering efficacy, tolerability and target organ protection of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). While not a systematic review, this article reviews the best available evidence in an attempt to clarify current uncertainty within medical practice regarding treatment options in patients with hypertension. ACEIs have been at the forefront of hypertension therapy for several years, especially in hypertensive at-risk patients. However, their use is restricted by burdensome side-effects and their limited ability to reach target blood pressure. Newer ARBs, such as telmisartan, have more sustained blood pressure control throughout the...Continue Reading

References

Sep 1, 1995·Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension·P F Semple
Oct 6, 1998·Journal of Human Hypertension·D Hughes, A McGuire
Aug 5, 1999·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·L Mazzolai, M Burnier
Dec 22, 1999·American Journal of Preventive Medicine·N A RigottiR C Pasternak
Jan 20, 2000·The New England Journal of Medicine·UNKNOWN Heart Outcomes Prevention Evaluation Study InvestigatorsG Dagenais
Jun 10, 2000·Quality in Health Care : QHC·T Treasure
Jun 15, 2000·Journal of Human Hypertension·Z H Israili
Apr 6, 2001·Clinical Cardiology·P CarsonH M Siragy
Jan 5, 2002·The New England Journal of Medicine·J N CohnUNKNOWN Valsartan Heart Failure Trial Investigators
Mar 13, 2002·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Laurence G Howes, Diane Tran
Aug 23, 2002·The New England Journal of Medicine·Juerg NussbergerMarco Cicardi
Dec 4, 2002·The Journal of Clinical Hypertension·George L Bakris, Matthew Weir
Jan 31, 2003·The Journal of Clinical Hypertension·Joel Neutel, David H G Smith
May 16, 2003·JAMA : the Journal of the American Medical Association·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Jul 5, 2003·The Annals of Pharmacotherapy·Brian K Irons, Ashwani Kumar
Aug 6, 2003·Blood Pressure Monitoring·David H G SmithStephen Koval
Sep 19, 2003·Lancet·Marc A PfefferUNKNOWN CHARM Investigators and Committees
Sep 19, 2003·Lancet·K M Fox, UNKNOWN EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators
Nov 12, 2003·The New England Journal of Medicine·Marc A PfefferUNKNOWN Valsartan in Acute Myocardial Infarction Trial Investigators
Dec 23, 2003·Journal of General Internal Medicine·Peter A UbelDavid A Asch
Apr 22, 2004·JAMA : the Journal of the American Medical Association·Michael A Fischer, Jerry Avorn
Jul 9, 2004·Current Opinion in Allergy and Clinical Immunology·Mark S Dykewicz
Aug 18, 2004·Blood Pressure Monitoring·Yves LacourcièreHelmut Schumacher
Jan 6, 2005·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·David H G SmithMichael Jones
Nov 11, 2005·American Journal of Hypertension·Guillaume BobrieUNKNOWN COmparative Study of Efficacy of Irbesartan/HCTZ with Valsartan/HCTZ Using Home Blood Pressure Monitoring in the TreAtment o
Dec 13, 2005·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Joel M NeutelUNKNOWN Telmisartan Study Group
Jan 10, 2006·Drugs·Anna J Battershill, Lesley J Scott
Aug 10, 2006·The Journal of Clinical Hypertension·Philippe Gosse, Helmut Schumacher

❮ Previous
Next ❯

Citations

Nov 1, 1976·The American Journal of Medicine·M A Devynck, P Meyer
Jul 15, 1979·European Journal of Pharmacology·J Mironneau, Y M Gargouil
Feb 15, 1979·European Journal of Pharmacology·A T ChiuR J Freer
Dec 5, 1980·European Journal of Pharmacology·J MironneauJ P Savineau
Mar 12, 1981·European Journal of Pharmacology·A M Abdel-HakimM Elhilali
Mar 4, 1983·European Journal of Pharmacology·N MiasiroA C Paiva
Aug 3, 1989·European Journal of Pharmacology·M E OshiroA C Paiva
Mar 14, 1989·European Journal of Pharmacology·F G VarolN H Neff
Aug 11, 1994·European Journal of Pharmacology·D Y ChengP J Kadowitz
Aug 15, 1996·European Journal of Pharmacology·H C ChampionP J Kadowitz
Jan 1, 1985·Neuroscience and Biobehavioral Reviews·R Quirion, P Gaudreau
Jun 11, 1993·Regulatory Peptides·D RegoliN E Rhaleb
Nov 10, 1995·Regulatory Peptides·J W Wright, J W Harding
Apr 1, 1992·Comparative Biochemistry and Physiology. Comparative Physiology·M C Breno, Z P Picarelli
Sep 12, 2000·European Journal of Pharmacology·B J De WittP J Kadowitz
May 7, 1998·European Journal of Pharmacology·R BouleyE Escher
Jul 3, 1998·European Journal of Pharmacology·D RegoliF J Gobeil
Dec 16, 1995·Lancet·G M Wray, J H Coakley
Nov 25, 1997·Brain Research. Brain Research Reviews·J W Wright, J W Harding
Jan 1, 1997·Peptides·S L ChambersJ W Harding
Sep 3, 2010·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Li YuLie Gao
Oct 12, 2012·Expert Opinion on Pharmacotherapy·L M Ruilope, Helmut Schumacher
Apr 8, 2016·Current Medical Research and Opinion·Christos V Rizos, Moses S Elisaf
Feb 2, 2012·Expert Review of Cardiovascular Therapy·Vivencio BarriosLuis Miguel Rincón
Jun 9, 2020·Frontiers in Pharmacology·Anida VelagicBarbara K Kemp-Harper
Jul 9, 2013·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Yan ZhaoNagara Tamaki

❮ Previous
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