Angiotensin receptor blockers and the kidney: possible advantages over ACE inhibition?

M. Cooper, R. Webb, M. de Gasparo
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引用次数: 11

Abstract

This review deals with similarities and differences between the effects of ACE inhibitors and AT1-receptor blockers in the kidney. Specific receptor blockade has demonstrated that the beneficial effects of AT1 blockers arise from two mechanisms: the reduction of the AT1 receptor mediated response and the increase in plasma levels of Ang II through the AT1-receptor blockade, which leads to increased stimulation of the AT2 receptor (the so-called yin-yang effect). Both ACE inhibition and AT1-receptor blockade provide significant renal protection in the majority of experimental animal models of kidney diseases. AT1 receptor blockade may offer additional clinical benefits over ACE inhibitor treatment, particularly in the kidney, where AT1-receptor blockade does not cause the fall in glomerular filtration rate seen with ACE inhibitor treatment. A number of long-term clinical studies currently running should show the real value of this new class of compounds in the management of hypertension and associated cardiorenal diseases.
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血管紧张素受体阻滞剂和肾脏:可能优于ACE抑制?
本文综述了ACE抑制剂和at1受体阻滞剂在肾脏中的作用的异同。特异性受体阻断已经证明,AT1阻滞剂的有益作用来自两个机制:AT1受体介导的反应的减少和通过AT1受体阻断导致的血浆Ang II水平的增加,从而导致对AT2受体的刺激增加(所谓的阴阳效应)。在大多数肾脏疾病的实验动物模型中,ACE抑制和at1受体阻断均具有显著的肾保护作用。与ACE抑制剂治疗相比,AT1受体阻断可能提供额外的临床益处,特别是在肾脏方面,AT1受体阻断不会导致肾小球滤过率下降,而ACE抑制剂治疗则会出现这种情况。目前正在进行的一些长期临床研究应该会显示出这类新型化合物在高血压和相关心肾疾病治疗中的真正价值。
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Abbott-57219[SCH-40054]: A Novel Nasal Decongestant DPI 201-106 Bopindolol: Pharmacological Basis and Clinical Implications Cardiovascular effects of raloxifene hydrochloride. Angiotensin receptor blockers and the kidney: possible advantages over ACE inhibition?
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