1
|
Zhu L, Wei GC, Xiao Q, Chen QL, Zhao Q, Li XX, Pan LA, Xiong X. Efficacy and safety of azilsartan medoxomil in the treatment of hypertension: a systematic review and meta-analysis. Front Cardiovasc Med 2024; 11:1383217. [PMID: 39026999 PMCID: PMC11254823 DOI: 10.3389/fcvm.2024.1383217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Background Angiotensin II receptor blockers (ARBs) are utilized for the management of hypertension and diabetes. Previous meta-analyses suggested that azilsartan medoxomil (AZL-M) improved blood pressure (BP) reduction, but there were no safety findings or suggestions for patients with hypertension or diabetes. Methods We performed an efficacy and safety meta-analysis of randomized controlled trials (RCTs) evaluating AZL-M therapy for reducing BP in patients with hypertension. Patients with hypertension complicated by diabetes were analyzed. The relevant literature was searched in English and Chinese databases for RCTs involving AZL-M in hypertension. Efficacy variables included the change from baseline in the 24-h mean systolic/diastolic BP measured by ambulatory BP monitoring, the change from baseline in clinic systolic/diastolic BP, and responder rates. Safety variables included total adverse events (AEs), serious AEs, AEs leading to discontinuation, and AEs related to the study drug. The raw data from the included studies were utilized to calculate the odds ratio (OR) for dichotomous data and the mean difference (MD) for continuous data, accompanied by 95% confidence intervals (CIs). Statistical analysis was performed using R software. Results A total of 11 RCTs met the inclusion criteria, representing 7,608 patients, 5 of whom had diabetes. Pooled analysis suggested a reduction in BP among patients randomized to 40 mg of AZL-M vs. control therapy [24-h ambulatory blood pressure monitoring (ABPM) mean systolic blood pressure (SBP) (MD: -2.85 mmHg), clinic SBP (MD: -3.48 mmHg), and clinic diastolic blood pressure (DBP) (MD: -1.96 mmHg)] and for 80 mg of AZL-M vs. control therapy [24-h ABPM mean SBP (MD: -3.59 mmHg), 24-h ABPM mean DBP (MD: -2.62 mmHg), clinic SBP (MD: -4.42 mmHg), clinic DBP (MD: -3.09 mmHg), and responder rate (OR: 1.46)]. There was no difference in the reduction of risks, except for dizziness (OR: 1.56) in the 80-mg AZL-M group or urinary tract infection (OR: 1.82) in the 40-mg AZL-M group. Analysis of patients with diabetes revealed that AZL-M can provide superior management, while safety and tolerability were similar to those of control therapy. Conclusions AZL-M appears to reduce BP to a greater extent than dose-control therapy and does not increase the risk of adverse events in patients with hypertension and diabetes compared with placebo. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=464284, identifier PROSPERO CRD42023464284.
Collapse
Affiliation(s)
- Ling Zhu
- Department of Pharmacy, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Guo-Cui Wei
- Department of Pharmacy, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qing Xiao
- Department of Pharmacy, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian-Lan Chen
- Department of Pharmacy, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Zhao
- Department of Pharmacy, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiu-xia Li
- Department of Pharmacy, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling-ai Pan
- Department of Critical Care Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuan Xiong
- Department of Pharmacy, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
2
|
Gilarevsky SR. [Changing Concepts About Optimal Target Blood Pressure and the Therapeutic Advantages of Azilsartan for Achieving it]. KARDIOLOGIIA 2024; 64:61-70. [PMID: 38742517 DOI: 10.18087/cardio.2024.4.n2646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/20/2024] [Indexed: 05/16/2024]
Abstract
The article discusses current issues of the treatment of arterial hypertension. According to presented data, so-called therapeutic nihilism is becoming one of the main barriers to achieving target blood pressure (BP). This nihilism is that despite evidence of the effectiveness of achieving lower BP values, practitioners do not intensify antihypertensive therapy sufficiently to achieve such values. The article specially addresses new criteria for the effectiveness of antihypertensive therapy, which reflect the therapy sustainability. The most commonly used indicator is the duration of the period, during which systolic BP remains in the therapeutic range. The prognostic significance of such indicators is discussed. In these conditions, it is very important to use the most effective antihypertensive drugs for initial antihypertensive therapy, including as a part of combination therapy. This tactic provides more frequent achievement of BP goals without the need for dose adjustment. In this regard, a systematic review was performed, which included sufficiently large randomized studies of the antihypertensive effectiveness of azilsartan medoxomil. This systematic review will provide comprehensive information on a possible role of using the angiotensin II receptor blocker azilsartan as a basic drug for the treatment of a wide range of patients with high BP. Most of the studies included in the systematic review assessed the effectiveness of combination therapy including azilsartan.
Collapse
Affiliation(s)
- S R Gilarevsky
- Russian Gerontology Research and Clinical Center, Moscow
| |
Collapse
|
3
|
Dash A, Meher BR, Padhy BM, Mohanty RR, Tripathy A. Comparison of Efficacy and Safety of Azilsartan and Amlodipine Combination Versus Telmisartan and Amlodipine Combination in Hypertensive Patients: A Non-inferiority Trial. Cureus 2023; 15:e35865. [PMID: 37033509 PMCID: PMC10078117 DOI: 10.7759/cureus.35865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Hypertension (HTN) is one of the most common conditions encountered in daily practice in hospitals. Combination therapy is mostly initiated in the management of HTN when target blood pressure is not achieved with monotherapy. There are few studies comparing the antihypertensive effect of a combination of azilsartan and amlodipine with a combination of amlodipine and other angiotensin receptor blockers (ARBs), however, the results are contradictory. The objective of this study was to compare the efficacy and safety of the azilsartan and amlodipine combination versus the telmisartan and amlodipine combination in hypertensive patients. Methods The present study was a prospective, randomized, active-controlled, open-label, parallel-group clinical trial. Hypertensive patients were randomized into two groups of 25 patients each. Baseline evaluations of systolic blood pressure (SBP), diastolic blood pressure (DBP), and high-sensitivity troponin I (hsTnI) were done. Patients were reassessed after 12 weeks of drug therapy with azilsartan 40 mg and amlodipine 5 mg combination or telmisartan 40 mg once daily (QD) and amlodipine 5 mg combination QD. Results The response rate (defined as a reduction of more than 20 mm Hg in SBP or 10 mm Hg in DBP or both from baseline at 12 weeks) for HTN in the test group and control groups was found to be 88% and 96% respectively. The response rate of the azilsartan amlodipine group was found to be non-inferior to the telmisartan amlodipine group (odds ratio, OR, 0.31, p = 0.61) at the end of 12 weeks of drug therapy. At 12 weeks of follow-up, there was a significant decrease in SBP (p < 0.001), DBP (p < 0.001), and hsTnI levels (p < 0.001) in both groups from baseline values. However, differences between the test and control groups for blood pressure and hsTnI were found to be not statistically significant at 12 weeks of follow-up. The most commonly reported adverse effect in both groups was headache. Conclusion Azilsartan amlodipine combination had an 88% response rate, which was non-inferior to the telmisartan and amlodipine combination. Biomarkers such as hsTnI showed a significant decrease in both groups after 12 weeks of follow-up. However, there was no significant difference between the two groups.
Collapse
|
4
|
Johnson W, White WB, Sica D, Bakris GL, Weber MA, Handley A, Perez A, Cao C, Kupfer S, Saunders EB. Evaluation of the angiotensin
II
receptor blocker azilsartan medoxomil in African‐American patients with hypertension. J Clin Hypertens (Greenwich) 2017; 19:695-701. [PMID: 28493376 PMCID: PMC8031359 DOI: 10.1111/jch.12993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/09/2016] [Accepted: 12/30/2016] [Indexed: 01/13/2023]
Abstract
The efficacy and safety of azilsartan medoxomil (AZL‐M) were evaluated in African‐American patients with hypertension in a 6‐week, double‐blind, randomized, placebo‐controlled trial, for which the primary end point was change from baseline in 24‐hour mean systolic blood pressure (BP). There were 413 patients, with a mean age of 52 years, 57% women, and baseline 24‐hour BP of 146/91 mm Hg. Treatment differences in 24‐hour systolic BP between AZL‐M 40 mg and placebo (−5.0 mm Hg; 95% confidence interval, −8.0 to −2.0) and AZL‐M 80 mg and placebo (−7.8 mm Hg; 95% confidence interval, −10.7 to −4.9) were significant (P≤.001 vs placebo for both comparisons). Changes in the clinic BPs were similar to the ambulatory BP results. Incidence rates of adverse events were comparable among the treatment groups, including those of a serious nature. In African‐American patients with hypertension, AZL‐M significantly reduced ambulatory and clinic BPs in a dose‐dependent manner and was well tolerated.
Collapse
Affiliation(s)
| | - William B. White
- Cardiology CenterUniversity of Connecticut School of Medicine Farmington CT USA
| | - Domenic Sica
- Virginia Commonwealth University Health System Richmond VA USA
| | | | | | - Alison Handley
- Takeda Pharmaceuticals International Inc. Deerfield IL USA
| | - Alfonso Perez
- Takeda Development Center Americas Inc. Deerfield IL USA
| | | | - Stuart Kupfer
- Takeda Development Center Americas Inc. Deerfield IL USA
| | | |
Collapse
|
5
|
Georgiopoulos G, Katsi V, Oikonomou D, Vamvakou G, Koutli E, Laina A, Tsioufis C, Nihoyannopoulos P, Tousoulis D. Azilsartan as a Potent Antihypertensive Drug with Possible Pleiotropic Cardiometabolic Effects: A Review Study. Front Pharmacol 2016; 7:235. [PMID: 27536242 PMCID: PMC4971108 DOI: 10.3389/fphar.2016.00235] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 07/20/2016] [Indexed: 12/14/2022] Open
Abstract
Background: Hypertension related cardiovascular (CV) complications could be amplified by the presence of metabolic co-morbidities. Azilsartan medoxomil (AZL-M) is the eighth approved member of angiotensin II receptor blockers (ARBs), a drug class of high priority in the management of hypertensive subjects with diabetes mellitus type II (DMII). Methods: Under this prism, we performed a systematic review of the literature for all relevant articles in order to evaluate the efficacy, safety, and possible clinical role of AZL-M in hypertensive diabetic patients. Results: AZL-M was found to be more effective in terms of reducing indices of blood pressure over alternative ARBs or angiotensin-converting enzyme (ACE) inhibitors with minimal side effects. Preclinical studies have established pleiotropic effects for AZL-M beyond its primary antihypertensive role through differential gene expression, up-regulation of membrane receptors and favorable effect on selective intracellular biochemical and pro-atherosclerotic pathways. Conclusion: Indirect but accumulating evidence from recent literature supports the efficacy and safety of AZL-M among diabetic patients. However, no clinical data exist to date that evince a beneficial role of AZL-M in patients with metabolic disorders on top of its antihypertensive effect. Further clinical studies are warranted to assess the pleiotropic cardiometabolic benefits of AZL-M that are derived from preclinical research.
Collapse
Affiliation(s)
- Georgios Georgiopoulos
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| | - Vasiliki Katsi
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| | - Dimitrios Oikonomou
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| | - Georgia Vamvakou
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| | - Evangelia Koutli
- Department of Internal Medicine, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| | - Aggeliki Laina
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| | - Constantinos Tsioufis
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| | - Petros Nihoyannopoulos
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical SchoolAthens, Greece; Department of Cardiology, Imperial College London, Hammersmith HospitalLondon, UK
| | - Dimitrios Tousoulis
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece
| |
Collapse
|
6
|
Prajapati H, Barkate H, Sharma R. Azilsartan: from bench to bedside. DRUGS & THERAPY PERSPECTIVES 2016. [DOI: 10.1007/s40267-016-0308-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
7
|
Angeloni E. Azilsartan medoxomil in the management of hypertension: an evidence-based review of its place in therapy. CORE EVIDENCE 2016; 11:1-10. [PMID: 27103882 PMCID: PMC4829189 DOI: 10.2147/ce.s81776] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Azilsartan (AZI) is a relatively new angiotensin receptor blocker available for the treatment of any stage of hypertension, which was eventually given in combination with chlorthalidone (CLT). Objective To review pharmacology and clinical role of AZI monotherapy and AZI/CLT or AZI/amlodipine combination therapies for hypertension management. Methods PubMed, Embase, and Cochrane Library were searched using search terms “ azilsartan”, “chlorthalidone,” “pharmacology,” “pharmacokinetics,” “pharmacodynamics,” “pharmacoeconomics,” and “cost-effectiveness.” To obtain other relevant information, US Food and Drug Association as well as manufacturer prescribing information were also reviewed. Results Randomized controlled trials demonstrated AZI to be superior to other sartans, such as valsartan, olmesartan, and candesartan, in terms of 24-hour ambulatory blood pressure monitoring (ABPM) reduction with respect. That beneficial effect of azilsartan was also associated with similar safety profiles. When compared to other antihypertensive drugs, azilsartan was found to be superior to any angiotensin-converting enzyme inhibitor, including ramipril, in terms of ABPM results, and noninferior to amlodipine in terms of sleep-BP control. The association of AZI and CLT was then found to be superior to other sartans + thiazide combination therapies in terms of both BP lowering and goal achievement. The combination of AZI and amlodipine has also been tested in clinical trials, but compared only with placebo, demonstrating its superiority in terms of efficacy and similarity in terms of safety. Conclusion Azilsartan is a safe and effective treatment option for every stage of hypertension, both alone or in fixed-dose combination tablets with chlorthalidone or amlodipine. Beneficial effects of AZI were also noted in patients with any degree of renal impairment. In addition, safety profiles of AZI were similar to that of the placebo.
Collapse
Affiliation(s)
- Emiliano Angeloni
- Cardiovascular Pathophysiology and Imaging, Sapienza Università di Roma, Rome, Italy
| |
Collapse
|
8
|
Ma J, Wang XY, Hu ZD, Zhou ZR, Schoenhagen P, Wang H. Meta-analysis of the efficacy and safety of adding an angiotensin receptor blocker (ARB) to a calcium channel blocker (CCB) following ineffective CCB monotherapy. J Thorac Dis 2016; 7:2243-52. [PMID: 26793346 DOI: 10.3978/j.issn.2072-1439.2015.12.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND We conducted this meta-analysis to systematically review and analyze the clinical benefits of angiotensin receptor blocker (ARB) combined with calcium channel blocker (CCB) following ineffective CCB monotherapy. METHODS PubMed was searched for articles published until August 2015. Randomized controlled trials (RCTs) evaluating the clinical benefits of ARB combined with CCB following ineffective CCB monotherapy were included. The primary efficacy endpoint of the studies was normal rate of blood pressure, the secondary efficacy endpoints were the response rate and change in blood pressure from baseline. The safety endpoint of the studies was incidence of adverse events. Differences are expressed as relative risks (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes and weighted mean differences (WMDs) with 95% CIs for continuous outcomes. Heterogeneity across studies was tested by using the I(2) statistic. RESULTS Seven RCTs were included and had sample sizes ranging from 185 to 1,183 subjects (total: 3,909 subjects). The pooled analysis showed that the on-target rate of hypertension treatment was significantly higher in the amlodipine + ARB group than in the amlodipine monotherapy group (RR =1.59; 95% CI, 1.31-1.91; P<0.01). The response rate of systolic blood pressure (SBP) (RR =1.28; 95% CI, 1.04-1.58; P<0.01) and diastolic blood pressure (DBP) (RR =1.27; 95% CI, 1.12-1.44; P=0.04) were significantly higher in the amlodipine + ARB group than in the amlodipine monotherapy group. The change in SBP (RR =-3.56; 95% CI, -7.76-0.63; P=0.10) and DBP (RR =-3.03; 95% CI, -6.51-0.45; P=0.09) were higher in hypertensive patients receiving amlodipine + ARB but the difference did not reach statistical significance. ARB + amlodipine treatment carried a lower risk of adverse events relative to amlodipine monotherapy (RR =0.88; 95% CI, 0.80-0.96; P<0.01). CONCLUSIONS The results of our meta-analysis demonstrate that adding an ARB to CCB after initial ineffective CCB monotherapy, significantly improved blood pressure control and the percentage of on-target hypertension treatment with significantly reduced incidence of adverse events compared with continued CCB monotherapy.
Collapse
Affiliation(s)
- Jin Ma
- 1 Department of Cardiology, Yangpu Hospital, Tongji University, Shanghai 20090, China ; 2 Graduate School, Dalian Medical University, Dalian 116044, China ; 3 Department of Laboratory Medicine, General Hospital of Ji'nan Military Region, Ji'nan 250031, China ; 4 Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 5 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 6 Cleveland Clinic, Imaging Institute and Heart&Vascular Institute, Cleveland, USA
| | - Xiao-Yan Wang
- 1 Department of Cardiology, Yangpu Hospital, Tongji University, Shanghai 20090, China ; 2 Graduate School, Dalian Medical University, Dalian 116044, China ; 3 Department of Laboratory Medicine, General Hospital of Ji'nan Military Region, Ji'nan 250031, China ; 4 Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 5 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 6 Cleveland Clinic, Imaging Institute and Heart&Vascular Institute, Cleveland, USA
| | - Zhi-De Hu
- 1 Department of Cardiology, Yangpu Hospital, Tongji University, Shanghai 20090, China ; 2 Graduate School, Dalian Medical University, Dalian 116044, China ; 3 Department of Laboratory Medicine, General Hospital of Ji'nan Military Region, Ji'nan 250031, China ; 4 Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 5 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 6 Cleveland Clinic, Imaging Institute and Heart&Vascular Institute, Cleveland, USA
| | - Zhi-Rui Zhou
- 1 Department of Cardiology, Yangpu Hospital, Tongji University, Shanghai 20090, China ; 2 Graduate School, Dalian Medical University, Dalian 116044, China ; 3 Department of Laboratory Medicine, General Hospital of Ji'nan Military Region, Ji'nan 250031, China ; 4 Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 5 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 6 Cleveland Clinic, Imaging Institute and Heart&Vascular Institute, Cleveland, USA
| | - Paul Schoenhagen
- 1 Department of Cardiology, Yangpu Hospital, Tongji University, Shanghai 20090, China ; 2 Graduate School, Dalian Medical University, Dalian 116044, China ; 3 Department of Laboratory Medicine, General Hospital of Ji'nan Military Region, Ji'nan 250031, China ; 4 Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 5 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 6 Cleveland Clinic, Imaging Institute and Heart&Vascular Institute, Cleveland, USA
| | - Hao Wang
- 1 Department of Cardiology, Yangpu Hospital, Tongji University, Shanghai 20090, China ; 2 Graduate School, Dalian Medical University, Dalian 116044, China ; 3 Department of Laboratory Medicine, General Hospital of Ji'nan Military Region, Ji'nan 250031, China ; 4 Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 5 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 6 Cleveland Clinic, Imaging Institute and Heart&Vascular Institute, Cleveland, USA
| |
Collapse
|
9
|
Paulis L, Rajkovicova R, Simko F. New developments in the pharmacological treatment of hypertension: dead-end or a glimmer at the horizon? Curr Hypertens Rep 2015; 17:557. [PMID: 25893478 PMCID: PMC4412646 DOI: 10.1007/s11906-015-0557-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Arterial hypertension is the most prevalent controllable disease world-wide. Yet, we still need to further improve blood pressure control, deal with resistant hypertension, and we hope to reduce risk "beyond blood pressure." The number of candidate molecules aspiring for these aims is constantly declining. The new possible approaches to combat high blood pressure include neprilysin/neutral endopeptidase (NEP) inhibition, particularly when combined with an angiotensin receptor blockade (such as the ARNI, LCZ696), phosphodiesterase 5 (PDE5) inhibition (KD027/Slx-2101), natriuretic agents (PL3994), or a long-lasting vasointestinal peptide (VIP) analogue (PB1046). Other options exploit the protective arm of the renin-angiotensin-aldosterone system by stimulating the angiotensin AT2 receptor (compound 21), the Mas receptor (AVE-0991), or the angiotensin converting enzyme 2. Finally, we review the possibilities how to optimize the use of the available treatment options by using drug combinations or by tailoring therapy to each patient's angiotensin peptide profile.
Collapse
Affiliation(s)
- Ludovit Paulis
- />Institute of Pathophysiology, Faculty of Medicine, Comenius University, Sasinkova 4, 81108 Bratislava, Slovak Republic
- />Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Sienkiewiczova 1, 81371 Bratislava, Slovak Republic
| | - Romana Rajkovicova
- />Institute of Pathophysiology, Faculty of Medicine, Comenius University, Sasinkova 4, 81108 Bratislava, Slovak Republic
| | - Fedor Simko
- />Institute of Pathophysiology, Faculty of Medicine, Comenius University, Sasinkova 4, 81108 Bratislava, Slovak Republic
- />Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlárska 3, 83306 Bratislava, Slovak Republic
| |
Collapse
|
10
|
Baker WL, Nigro SC, White WB. Efficacy of azilsartan medoxomil with chlorthalidone in hypertension. Expert Rev Cardiovasc Ther 2014; 12:791-8. [DOI: 10.1586/14779072.2014.924853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|