RESUMEN
Angiotensin II antagonists (AIIAs) were introduced to treat hypertension about 10 years ago. During this period they were evaluated not only in terms of efficacy and safety but also in several large studies with clinical outcomes. They are efficacious in all clinical forms of hypertension and are effective also in all ethnic groups. Cardiovascular and renal protection in proteinuric diabetic nephropathy beyond blood pressure reduction was proved in major clinical studies: Losartan Intervention For Endpoint reduction in hypertension study (LIFE), Reduction of Endpoint in Non-Insulin dependent Diabetes Mellitus with the AII Antagonist Losartan (RENAAL) and Irbesartan Type 2 Diabetic Nephropathy Trial (IDNT). Their blood pressure independent protective effect is also mentioned by the blockade of AT1 receptor. As a class AIIs have a tolerability profile similar to placebo.
Os antagonistas da angiotensina II (AAIIs) foram introduzidos para o tratamento da hipertensão arterial há cerca de 10 anos. Durante esse período eles foram avaliados não apenas em termos de eficácia e segurança, mas também em vários estudos grandes com desfechos clínicos. Os AAIIs são eficazes em todas as formas clínicas de hipertensão e, também, em todos os grupos étnicos. Os principais estudos clínicos em pacientes diabéticos com nefropatia e proteinúia comprovaram, além da redução da pressão arterial, proteção cardiovascular e renal: "Losartan Intervention For Endpoint reduction in hypertension study" (LIFE), "Reduction of Endpoint in Non-Insulin dependent Diabetes Mellitus with the AII Antagonist Losartan" (RENAAL) e "Irbesartan Type 2 Diabetic Nephropathy Trial" (IDNT). O seu efeito protetor independente da pressão sanguínea também é mencionado pelo bloqueio do receptor AT1. Os AAIIs, como classe medicamentosa, apresentam um perfil de tolerabilidade semelhante ao placebo.
Asunto(s)
Humanos , Bloqueadores del Receptor Tipo 1 de Angiotensina II/uso terapéutico , Angiotensina II/antagonistas & inhibidores , Antihipertensivos/uso terapéutico , Compuestos de Bifenilo/uso terapéutico , Nefropatías Diabéticas/prevención & control , Hipertensión/tratamiento farmacológico , Proteinuria/prevención & control , Tetrazoles/uso terapéutico , Sistema Cardiovascular/efectos de los fármacos , Riñón/efectos de los fármacos , Losartán/uso terapéuticoRESUMEN
Essential hypertension is a common multifactorial disorder, resulting from a combined effect of the predisposing genetic and environmental risk factors. This review summarizes the collective efforts of epidemiologists, clinicians and molecular geneticists to unravel the genetic complexity of hypertension. The multifaceted approach to modern hypertension research that combines the tools of contemporary genetics and molecular biology, such as genome-wide analysis of genes and transcripts, with classical whole-animal physiological models of disease and the wealth of clinical observations, is discussed