Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current Recommendations
Giovanna Gallo,1 Massimo Volpe,1 Speranza Rubattu1,2 1Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy; 2IRCCS Neuromed, Pozzilli, IS, ItalyCorrespondence: Speranza Rubattu, Department of Clinical and Molecular Medicine, Sapienza Universit...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-07-01
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| Series: | Vascular Health and Risk Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/angiotensin-receptor-blockers-in-the-management-of-hypertension-a-real-peer-reviewed-fulltext-article-VHRM |
| _version_ | 1811297016189288448 |
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| author | Gallo G Volpe M Rubattu S |
| author_facet | Gallo G Volpe M Rubattu S |
| author_sort | Gallo G |
| collection | DOAJ |
| description | Giovanna Gallo,1 Massimo Volpe,1 Speranza Rubattu1,2 1Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy; 2IRCCS Neuromed, Pozzilli, IS, ItalyCorrespondence: Speranza Rubattu, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy, Tel +390633775979, Email speranzadonatella.rubattu@uniroma1.itAbstract: Hypertension represents a major common cardiovascular risk factor. Optimal control of high blood pressure levels is recommended to reduce the global burden of hypertensive-mediated organ damage and cardiovascular (CV) events. Among the first-line drugs recommended in international guidelines, renin-angiotensin-aldosterone system antagonists [angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs)] have long represented a rational, effective, and safe anti-hypertensive pharmacological strategy. In fact, current US and European guidelines recommend ACEi and ARBs as a suitable first choice for hypertension treatment together with calcium channel blockers (CCBs) and thiazide diuretics. Different studies have demonstrated that ARBs and ACEi exert a comparable effect in lowering blood pressure levels. However, ARBs are characterized by better pharmacological tolerability. Most importantly, the clinical evidence supports a relevant protective role of ARBs toward the CV and renal damage development, as well as the occurrence of major adverse CV events, in hypertensive patients. Moreover, a neutral metabolic effect has been reported upon ARBs administration, in contrast to other antihypertensive agents, such as beta-blockers and diuretics. These properties highlight the use of ARBs as an excellent pharmacological strategy to manage hypertension and its dangerous consequences. The present review article summarizes the available evidence regarding the beneficial effects and current recommendations of ARBs in hypertension. The specific properties performed by these agents in various clinical subsets are discussed, also including an overview of their implications for the current COVID-19 pandemic.Keywords: hypertension, renin-angiotensin-aldosterone system, ACEi, ARBs, HMOD, MACE |
| first_indexed | 2024-04-13T05:57:58Z |
| format | Article |
| id | doaj.art-8fca684ed13d493898e73a495559557d |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-04-13T05:57:58Z |
| publishDate | 2022-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-8fca684ed13d493898e73a495559557d2022-12-22T02:59:33ZengDove Medical PressVascular Health and Risk Management1178-20482022-07-01Volume 1850751576492Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current RecommendationsGallo GVolpe MRubattu SGiovanna Gallo,1 Massimo Volpe,1 Speranza Rubattu1,2 1Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy; 2IRCCS Neuromed, Pozzilli, IS, ItalyCorrespondence: Speranza Rubattu, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy, Tel +390633775979, Email speranzadonatella.rubattu@uniroma1.itAbstract: Hypertension represents a major common cardiovascular risk factor. Optimal control of high blood pressure levels is recommended to reduce the global burden of hypertensive-mediated organ damage and cardiovascular (CV) events. Among the first-line drugs recommended in international guidelines, renin-angiotensin-aldosterone system antagonists [angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs)] have long represented a rational, effective, and safe anti-hypertensive pharmacological strategy. In fact, current US and European guidelines recommend ACEi and ARBs as a suitable first choice for hypertension treatment together with calcium channel blockers (CCBs) and thiazide diuretics. Different studies have demonstrated that ARBs and ACEi exert a comparable effect in lowering blood pressure levels. However, ARBs are characterized by better pharmacological tolerability. Most importantly, the clinical evidence supports a relevant protective role of ARBs toward the CV and renal damage development, as well as the occurrence of major adverse CV events, in hypertensive patients. Moreover, a neutral metabolic effect has been reported upon ARBs administration, in contrast to other antihypertensive agents, such as beta-blockers and diuretics. These properties highlight the use of ARBs as an excellent pharmacological strategy to manage hypertension and its dangerous consequences. The present review article summarizes the available evidence regarding the beneficial effects and current recommendations of ARBs in hypertension. The specific properties performed by these agents in various clinical subsets are discussed, also including an overview of their implications for the current COVID-19 pandemic.Keywords: hypertension, renin-angiotensin-aldosterone system, ACEi, ARBs, HMOD, MACEhttps://www.dovepress.com/angiotensin-receptor-blockers-in-the-management-of-hypertension-a-real-peer-reviewed-fulltext-article-VHRMhypertensionrenin-angiotensin-aldosterone systemaceiarbshmodmace |
| spellingShingle | Gallo G Volpe M Rubattu S Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current Recommendations Vascular Health and Risk Management hypertension renin-angiotensin-aldosterone system acei arbs hmod mace |
| title | Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current Recommendations |
| title_full | Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current Recommendations |
| title_fullStr | Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current Recommendations |
| title_full_unstemmed | Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current Recommendations |
| title_short | Angiotensin Receptor Blockers in the Management of Hypertension: A Real-World Perspective and Current Recommendations |
| title_sort | angiotensin receptor blockers in the management of hypertension a real world perspective and current recommendations |
| topic | hypertension renin-angiotensin-aldosterone system acei arbs hmod mace |
| url | https://www.dovepress.com/angiotensin-receptor-blockers-in-the-management-of-hypertension-a-real-peer-reviewed-fulltext-article-VHRM |
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