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Angiotensin II type 1 receptor antagonists in the treatment of hypertension in elderly patients: focus on patient outcomes.

Tadevosyan A, Maclaughlin EJ, Karamyan VT - Patient Relat Outcome Meas (2011)

Bottom Line: Recent clinical studies in the elderly have provided evidence that angiotensin II type 1 (AT(1)) receptor antagonists can improve clinical outcomes to a similar or, in certain populations, an even greater extent than other classical arterial blood pressure-lowering agents.This newer class of antihypertensive agents presents several benefits, including potential for improved adherence, excellent tolerability profile with minimal first-dose hypotension, and a low incidence of adverse effects.Thus, AT(1) receptor antagonists represent an appropriate option for many elderly patients with hypertension, type 2 diabetes, heart failure, and/or left ventricular dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Departments of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, QC, Canada;

ABSTRACT
Hypertension in the elderly is one of the main risk factors of cardiovascular and cerebrovascular diseases. Knowledge regarding the mechanisms of hypertension and specific considerations in managing hypertensive elderly through pharmacological intervention(s) is fundamental to improving clinical outcomes. Recent clinical studies in the elderly have provided evidence that angiotensin II type 1 (AT(1)) receptor antagonists can improve clinical outcomes to a similar or, in certain populations, an even greater extent than other classical arterial blood pressure-lowering agents. This newer class of antihypertensive agents presents several benefits, including potential for improved adherence, excellent tolerability profile with minimal first-dose hypotension, and a low incidence of adverse effects. Thus, AT(1) receptor antagonists represent an appropriate option for many elderly patients with hypertension, type 2 diabetes, heart failure, and/or left ventricular dysfunction.

No MeSH data available.


Related in: MedlinePlus

Schematic illustration of the RAAS and the main pathways by which RAAS regulates cardiovascular function.148,149Abbreviations: ACE, angiotensin-converting enzyme; ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; CNS, central nervous system; NE, norepinephrine; RAAS, renin–angiotensin–aldosterone system; RSN, renal sympathetic nerve; ROS, reactive oxygen species.
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f1-prom-2-027: Schematic illustration of the RAAS and the main pathways by which RAAS regulates cardiovascular function.148,149Abbreviations: ACE, angiotensin-converting enzyme; ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; CNS, central nervous system; NE, norepinephrine; RAAS, renin–angiotensin–aldosterone system; RSN, renal sympathetic nerve; ROS, reactive oxygen species.

Mentions: Angiotensin receptor antagonists act on the final step of the renin–angiotensin–aldosterone system (RAAS) by selectively blocking the AT1 receptor and preventing the effects of angiotensin II mediated by this receptor (Figure 1). Blockade of the AT1 receptor by angiotensin receptor blockers (ARBs) results in a dose-dependent fall of peripheral resistance without a significant change in the heart rate or cardiac output.23 ARBs offer a variety of advantages for elderly hypertensive patients; they have excellent tolerability, have minimal drug interactions, and may be dosed once daily.24 Because of these factors, medication adherence may also be optimized, which is particularly important considering that polypharmacy is common among hypertensive elderly.25


Angiotensin II type 1 receptor antagonists in the treatment of hypertension in elderly patients: focus on patient outcomes.

Tadevosyan A, Maclaughlin EJ, Karamyan VT - Patient Relat Outcome Meas (2011)

Schematic illustration of the RAAS and the main pathways by which RAAS regulates cardiovascular function.148,149Abbreviations: ACE, angiotensin-converting enzyme; ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; CNS, central nervous system; NE, norepinephrine; RAAS, renin–angiotensin–aldosterone system; RSN, renal sympathetic nerve; ROS, reactive oxygen species.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3417921&req=5

f1-prom-2-027: Schematic illustration of the RAAS and the main pathways by which RAAS regulates cardiovascular function.148,149Abbreviations: ACE, angiotensin-converting enzyme; ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; CNS, central nervous system; NE, norepinephrine; RAAS, renin–angiotensin–aldosterone system; RSN, renal sympathetic nerve; ROS, reactive oxygen species.
Mentions: Angiotensin receptor antagonists act on the final step of the renin–angiotensin–aldosterone system (RAAS) by selectively blocking the AT1 receptor and preventing the effects of angiotensin II mediated by this receptor (Figure 1). Blockade of the AT1 receptor by angiotensin receptor blockers (ARBs) results in a dose-dependent fall of peripheral resistance without a significant change in the heart rate or cardiac output.23 ARBs offer a variety of advantages for elderly hypertensive patients; they have excellent tolerability, have minimal drug interactions, and may be dosed once daily.24 Because of these factors, medication adherence may also be optimized, which is particularly important considering that polypharmacy is common among hypertensive elderly.25

Bottom Line: Recent clinical studies in the elderly have provided evidence that angiotensin II type 1 (AT(1)) receptor antagonists can improve clinical outcomes to a similar or, in certain populations, an even greater extent than other classical arterial blood pressure-lowering agents.This newer class of antihypertensive agents presents several benefits, including potential for improved adherence, excellent tolerability profile with minimal first-dose hypotension, and a low incidence of adverse effects.Thus, AT(1) receptor antagonists represent an appropriate option for many elderly patients with hypertension, type 2 diabetes, heart failure, and/or left ventricular dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Departments of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, QC, Canada;

ABSTRACT
Hypertension in the elderly is one of the main risk factors of cardiovascular and cerebrovascular diseases. Knowledge regarding the mechanisms of hypertension and specific considerations in managing hypertensive elderly through pharmacological intervention(s) is fundamental to improving clinical outcomes. Recent clinical studies in the elderly have provided evidence that angiotensin II type 1 (AT(1)) receptor antagonists can improve clinical outcomes to a similar or, in certain populations, an even greater extent than other classical arterial blood pressure-lowering agents. This newer class of antihypertensive agents presents several benefits, including potential for improved adherence, excellent tolerability profile with minimal first-dose hypotension, and a low incidence of adverse effects. Thus, AT(1) receptor antagonists represent an appropriate option for many elderly patients with hypertension, type 2 diabetes, heart failure, and/or left ventricular dysfunction.

No MeSH data available.


Related in: MedlinePlus