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July 10, 1995

The Angiotensin II Type 1 Receptor Antagonists: A New Class of Antihypertensive Drugs

Author Affiliations

From the Medical Service, Harry S Truman Memorial Veterans Hospital, and the Department of Internal Medicine, University of Missouri School of Medicine, Columbia.

Arch Intern Med. 1995;155(13):1361-1368. doi:10.1001/archinte.1995.00430130027004

The angiotensin II (AII) type 1 receptor antagonists represent a new pharmacologic class of drugs that are specifically designed to displace All from its type 1 receptor subtype. These drugs antagonize AII-induced biologic actions, including smooth-muscle contraction, sympathetic pressor mechanisms, and aldosterone release. Initial clinical trials suggest that these drugs are effective in the treatment of essential hypertension and hypertensive patients with intrinsic renal disease. Thus, they are the newest addition to the therapeutic armamentarium for the treatment of hypertensive diseases. We review the developmental history and pharmacology of the All type 1 receptor antagonists. We specifically discuss the following factors: mechanism(s) of action; members under clinical investigation; effects on renal function, salt and water excretion, and plasma renin activity, plasma All type 1, and plasma aldosterone concentrations; and efficacy and safety. Given the demonstrable benefits of All type 1 receptor blockade, these drugs should achieve broad utility in the treatment of hypertensive diseases.

(Arch Intern Med. 1995;155:1361-1368)