缬沙坦:十多年的经验。

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黑色的人力资源,贝利J, Zappe D,塞缪尔·R

缬沙坦:十多年的经验。

药。2009;69 (17):2393 - 414。doi: 10.2165 / 11319460-000000000-00000。

PubMed ID
19911855 (在PubMed
]
文摘

缬沙坦是一种nonpeptide血管紧张素受体拮抗剂,选择性地阻断血管紧张素ⅱ绑定的血管紧张素ⅱ1型受体。缬沙坦的疗效、耐受性和安全性已在大规模研究高血压,心力衰竭(HF)和post-myocardial梗死(MI)。本文着重从缬沙坦临床研究计划是什么和其他比较试验从1997年出版到现在。必威国际app许多研究已经证明了缬沙坦的功效降低血压(BP)在不同的患者群体(包括老人、妇女、儿童、肥胖患者,糖尿病患者,慢性肾脏疾病(CKD),患者高危患者心血管疾病(CV)、非洲裔美国人、西班牙裔美国人和亚洲人)和改善结果在心血管疾病和慢性肾病。在高血压、缬沙坦展品功效降低收缩压和舒张压都存在剂量依赖的相关性在每日一次80 - 320毫克的剂量范围;剂量高达640毫克/天已进行过研究并发现是有效的和安全的。BP控制可以提高更一致的24小时BP-lowering概要文件通过使用单片,固定剂量联合治疗与缬沙坦+氢氯噻嗪(HCTZ)。缬沙坦的心血管益处已经在大规模的试验结果证明,包括显著减少心血管发病率和死亡率在高频,MI后,和共病性高血压和冠状动脉疾病的患者和/或高频;减少心力衰竭住院;和减少中风的发病率。 The magnitude of these effects is comparable with that demonstrated with angiotensin-converting enzyme (ACE) inhibitors; however, valsartan has a more favourable tolerability profile, with a significantly lower incidence of cough and only rare reports of angio-oedema, both class effects of ACE inhibitor use. Consistent with its angiotensin receptor-blocking effects, valsartan also reduces circulating levels of biochemical markers that are associated with angiotensin II-mediated endothelial dysfunction and CV risk (e.g. high-sensitivity C-reactive protein or oxidized low-density lipoprotein). Improvements in CKD with valsartan include statistically and clinically meaningful reductions in urinary albumin and protein excretion in patients with type 2 diabetes and in nondiabetic patients with CKD. In short-term studies, valsartan has improved or stabilized various indices of metabolic function in at-risk patients, including those with co-morbid hypertension, obesity and/or metabolic syndrome. Because of this, valsartan is being prospectively investigated for its ability to reduce the incidence of new-onset diabetes and provide cardioprotection in patients with impaired glucose tolerance. Valsartan and valsartan/HCTZ are well tolerated. In clinical trials, adverse events during valsartan treatment were similar to those occurring with placebo. The combination of valsartan/HCTZ was better tolerated than HCTZ alone. Valsartan is administered once daily for hypertension; doses are usually taken upon awakening. In patients with HF or MI, valsartan is administered twice daily.

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