Perspectivas futuras del tratamiento con antagonistas de los recepetores de la angiotensina

Angiotensin II receptor blockers (ARB) are the most recently approved class of antihypertensive agents. They selectively block the angiotensin II type 1 receptor, thus inhibiting most of the deleterious effects of angiotensin II. In addition to blood pressure control, other benefits may be gained using ARB. This is because the renin-angiotensin system plays a crucial role in circulatory homeostasis, and in patients with atherosclerosis, diabetes or hypertension, angiotensin II contributes to the pathophysiology of disease. Evidence-based medicine includes well-controlled studies with mortality and morbidity endpoints in patients with a variety of conditions including hypertension, type 2 diabetes, stroke, renal disease, heart failure, left ventricular hypertrophy, and coronary heart diseases. In addition to these hard endpoints, it has been shown that treatment with ARB prevents the development of type-2 diabetes, ameliorates coronary and peripheral vascular endothelial dysfunction and decreases plasma levels of several markers of vascular inflammation.