Abstract
Rationale. The goal of antihypertensive treatment is to reduce risk of cardiovascular morbidity and mortality. Apart from blood pressure lowering per se, also reducing the activities of the renin-angiotensin system and sympathetic nervous system appears to be important. Angiotensin II receptor blocker drugs (ARBs) have provided a useful class of anti-hypertensive drugs. Eprosartan is a relatively new ARB which is chemically distinct (non-biphenyl, non-tetrazole) from all other ARBs (biphenyl tetrazoles). An analysis has been made on available experimental and clinical data on eprosartan which not only is an effective and well tolerated antihypertensive agent, but also lowers the activities of the renin-angiotensin system and sympathetic nervous system. Experimental and pharmacokinetic studies on eprosartan have shown differences with the other ARBs. The distinct properties of this non-biphenyl, non-tetrazole ARB might be relevant in the effort to reduce cardiovascular risk, also beyond its blood pressure lowering capacity.
Highlights
The purpose of treating patients with increased cardiovascular risk is to reduce that risk
As a consequence, counteracting the mechanisms involved in the pathogenesis of cardiovascular organ damage is important, independent of any direct blood pressure lowering effect
It is well established that angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) reduce the effects of angiotensin II Fig. (1). These therapies appear to have sympatholytic properties, which may be important in determining the efficacy of these agents in reducing cardiovascular risk, since there is abundant evidence that sympathetic hyperactivity is associated with poor clinical outcome
Summary
The purpose of treating patients with increased cardiovascular risk is to reduce that risk. It is well established that blood pressure lowering per se substantially reduces cardiovascular risk Both the renin-angiotensin system (RAS) and the sympathetic nervous system (SNS) play an important role in the pathogenesis of various forms of hypertension. Independent of their effect on blood pressure, these systems contribute to the pathophysiology of both structural and functional cardiovascular abnormalities. These therapies appear to have sympatholytic properties, which may be important in determining the efficacy of these agents in reducing cardiovascular risk, since there is abundant evidence that sympathetic hyperactivity is associated with poor clinical outcome In this brief review, we outline the interactions between the RAS and the SNS. 254 Cardiovascular & Hematological Agents in Medicinal Chemistry, 2008, Vol 6, No 4
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