Angiotensin Receptor Blockers
2003; Lippincott Williams & Wilkins; Volume: 107; Issue: 24 Linguagem: Inglês
10.1161/01.cir.0000072344.12827.13
ISSN1524-4539
Autores Tópico(s)Coagulation, Bradykinin, Polyphosphates, and Angioedema
ResumoHomeCirculationVol. 107, No. 24Angiotensin Receptor Blockers Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBAngiotensin Receptor Blockers Steven G. Terra Steven G. TerraSteven G. Terra From Pfizer Global Research and Development, Groton, Conn. Originally published24 Jun 2003https://doi.org/10.1161/01.CIR.0000072344.12827.13Circulation. 2003;107:e215–e216Angiotensin receptor blockers (also known as ARBs) are a class of medications that are widely used by patients with high blood pressure, kidney disease, and heart failure. This article provides information for patients who receive this type of medication. The Table lists the brand and chemical names for the angiotensin receptor blockers that are available in the United States. List of Angiotensin Receptor Blockers Available in the United StatesTrade Name (Manufacturer)Chemical NameCozaar (Merck)losartanHyzaar (Merck)losartan/hydrochlorothiazideAvapro (Bristol-Myers Squibb)irbesartanAvalide (Bristol-Myers Squibb)irbesartan/hydrochlorothiazideDiovan (Novartis)valsartanDiovan HCT (Novartis)valsartan/hydrochlorothiazideAtacand (AstraZeneca)candesartan cilexetilAtacand HCT (AstraZeneca)candesartan cilexetil/hydrochlorothiazideTeveten (Solvay Pharma Inc)eprosartanTeveten HCT (Solvay Pharma Inc)eprosartan/hydrochlorothiazideMicardis (Boehringer Ingelheim)telmisartanMicardis HCT (Boehringer Ingelheimtelmisartan/hydrochlorothiazideBenicar (Sankyo Pharma, Inc)olmesartanHow Do Angiotensin Receptor Blockers Work?Angiotensin receptor blockers work by inhibiting the effects of a hormone called angiotensin 2, which produces a number of effects in the body: Constriction of blood vessels, increased salt and water retention, activation of the sympathetic nervous system, stimulation of blood vessel and heart fibrosis (stiffening), and promotion of heart cell growth. Together, these effects can increase blood pressure and in some situations be harmful to the heart and kidneys. For angiotensin 2 to produce its effects in the body, it must bind to a receptor in much the same way that a key must fit into a lock to open a door. Angiotensin receptor blockers prevent angiotensin 2 from binding to its receptor and thus reduce the effects of angiotensin 2.Most of the angiotensin receptor blockers, except for Benicar (Sankyo Pharma, Inc), are also available in combination with an additional medication called hydrochlorothiazide (HCTZ), a diuretic that is very effective in lowering blood pressure. The blood pressure-lowering effects of angiotensin receptor blockers are made more effective by the addition of HCTZ. Therefore, your doctor may prescribe a combination product containing an angiotensin receptor blocker plus HCTZ if you require additional blood pressure lowering.What Conditions Are Treated With an Angiotensin Receptor Blocker?All angiotensin receptor blockers can be used to treat high blood pressure. In addition, both Cozaar (Merck) and Avapro (Bristol-Myers Squibb) are also used to prevent kidney damage in patients who have high blood pressure, and one angiotensin receptor blocker is used to treat patients who have heart failure but who cannot tolerate a related class of medications called angiotensin-converting enzyme (ACE) inhibitors. However, angiotensin receptor blockers can be used to treat other heart conditions, so speak with your doctor if you are not clear about the reason that you are receiving this class of medication.What Are the Common Side Effects of Angiotensin Receptor Blockers?Any medication that lowers blood pressure can cause dizziness. Frequent dizziness or lightheadedness may be an indication that your blood pressure is too low. If this occurs, you should speak with your doctor. You may find that changing positions slowly (such as going from lying down to standing up) may minimize dizziness. In very rare cases, patients receiving this class of medication have developed swelling of the lips, tongue, or face. You should contact your physician immediately if you experience any facial swelling or trouble breathing. You should also notify your physician if you have experienced facial swelling or difficulty breathing with any other medications in the past.In some susceptible individuals, angiotensin receptor blockers can cause increases in potassium and changes in kidney function. To monitor for these side effects, your doctor may do routine blood work. Many patients with high blood pressure are told to minimize their use of sodium. Some of these patients use salt substitutes instead. However, some of these salt substitutes contain potassium (instead of sodium), which when taken with an angiotensin receptor blocker, may increase the amount of potassium in your blood. It is a good idea to talk with your doctor before using any of these salt substitutes, especially if you have kidney disease or heart failure.You should not take angiotensin receptor blockers if you are pregnant or plan on becoming pregnant because this class of medication can cause harm to the unborn fetus.Are There Any Medications That I Should Not Combine With My Angiotensin Receptor Blocker?You should always inform your doctor and pharmacist of all the medications you are taking. This includes prescription and over-the-counter medications, along with any vitamins and herbal products. If you are taking an angiotensin receptor blocker for either high blood pressure or heart failure, you should speak with your doctor before taking any decongestants. Decongestants, which are available in many over-the-counter cough and cold products, can increase blood pressure. The most widely used decongestant is pseudoephedrine. In addition, in some individuals, nonsteroidal antiinflammatory drugs such as ibuprofen, naproxen, and indomethacin may elevate blood pressure, thus blunting the blood pressure-lowering effect of angiotensin receptor blockers. Speak with your doctor before taking these medications. One angiotensin receptor blocker, Micardis (Boehringer Ingelheim) may interact with the medication Lanoxin (GlaxoSmithKline; digoxin). Therefore, the level of digoxin in your blood should be monitored when you begin taking Micardis or have the dose increased or decreased. Because of this interaction, another angiotensin receptor blocker may be more appropriate if you are also receiving Lanoxin (digoxin).Does It Matter if Take My Angiotensin Receptor Blocker With or Without Food?Angiotensin receptor blockers can be taken with or without food. It is however, important that you take your medication at approximately the same time each day to maintain a consistent concentration of the medication in your body.FootnotesCorrespondence to Steven G. Terra, PharmD, Pfizer Global Research and Development, 445 Eastern Point Rd, MS 8260/2505, Groton, CT, 06340. E-mail [email protected]Additional InformationWebMD. Health guide A–Z: angiotensin II receptor blockers (ARBs). Available at: http://my.webmd.com/content/healthwise/174/55175.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}. Accessed May 8, 2003.Google ScholarAmerican Heart Association home page. Available at: http://www.americanheart.org. Accessed May 8, 2003.Google Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Mohamed Pakkir Maideen N, Balasubramanian R, Muthusamy S and Nallasamy V An Overview of Clinically Imperative and Pharmacodynamically Significant Drug Interactions of Renin-Angiotensin-Aldosterone System (RAAS) Blockers, Current Cardiology Reviews, 10.2174/1573403X18666220511152330, 18:6 Hockham C, Kotwal S, Wilcox A, Bassi A, McGree J, Pollock C, Burrell L, Bathla N, Kunigari M, Rathore V, John M, Lin E, Jenkins C, Ritchie A, McLachlan A, Snelling T, Jones M, Jha V and Jardine M (2021) Protocol for the Controlled evaLuation of Angiotensin Receptor blockers for COVID-19 respIraTorY disease (CLARITY): a randomised controlled trial, Trials, 10.1186/s13063-021-05521-0, 22:1 Leite L, Santiago H, de Lima D, Pires W and Coimbra C (2019) Central losartan administration increases cardiac workload during aerobic exercise, Neuropeptides, 10.1016/j.npep.2019.101960, 77, (101960), Online publication date: 1-Oct-2019. Moura A, Pires W, Leite L, da Cunha D, Peçanha T, de Lima J, Natali A and Prímola-Gomes T (2016) Power spectrum analysis of cardiovascular variability during passive heating in conscious rats, Journal of Thermal Biology, 10.1016/j.jtherbio.2016.08.011, 62, (20-29), Online publication date: 1-Dec-2016. Rishi A and Garland K (2015) Unusual Severe Side Effect of a Commonly Used Drug, The Journal of Clinical Hypertension, 10.1111/jch.12705, 18:4, (363-363), Online publication date: 1-Apr-2016. Ahad A, Al-Mohizea A, Al-Jenoobi F and Aqil M (2014) Transdermal delivery of angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs) and others for management of hypertension, Drug Delivery, 10.3109/10717544.2014.942444, 23:2, (579-590), Online publication date: 12-Feb-2016. LEITE L, RODRIGUES A, SOARES D, MARUBAYASHI U and COIMBRA C (2010) Central Fatigue Induced by Losartan Involves Brain Serotonin and Dopamine Content, Medicine & Science in Sports & Exercise, 10.1249/MSS.0b013e3181d03d36, 42:8, (1469-1476), Online publication date: 1-Aug-2010. June 24, 2003Vol 107, Issue 24 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000072344.12827.13PMID: 12821593 Originally publishedJune 24, 2003 PDF download Advertisement
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