Document Detail


Improving the managed care of hypertension with angiotensin II antagonists.
MedLine Citation:
PMID:  11814138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Among the modifiable risk factors for cardiovascular disease, hypertension is the most powerful and treatable. For an asymptomatic patient to remain on a lifetime of antihypertensive treatment that might cause adverse effects is difficult for most patients. Managed care plans should treat hypertensive patients in ways that the patient can remain on therapy to prevent complications and thereby reduce the long-term costs associated with untreated hypertension. The recent disappointing outcomes achieved with antihypertensive drugs suggest there is room for improvement in the management of hypertension. Since the introduction of the first orally active angiotensin II receptor blocking drug, losartan, attention has been focused on the central role of angiotensin II in hypertension and cardiovascular disease. Studies of angiotensin II antagonists (AIIAs), which block the tissue receptor for angiotensin II, show that these agents effectively control hypertension when given once daily and cause no significant adverse effects or laboratory abnormalities. Losartan is unique among the AIIAs in that it offers 1-step titration dosing and has a uricosuric effect. Losartan, candesartan, and valsartan have been shown to improve the symptoms of congestive heart failure; losartan has been similar to an angiotensin-converting enzyme inhibitor in reducing systolic dysfunction congestive heart failure mortality. At 1 year, the refill rate for losartan in a managed care setting has been more than that for any other class of antihypertensive agents. Although there is not yet a clinical trial determining the long term mortality of AIIA treatment in hypertension compared with other antihypertensive agents, the use of AIIAs in conjunction with lifestyle modification and patient education can provide more efficient hypertension control and a provide a treatment with which patients can live.
Authors:
Michael A Moore
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  323     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-29     Completed Date:  2002-02-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  25-33     Citation Subset:  AIM; IM    
Affiliation:
Hypertension Center, Department of Surgical Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. mamls@earthlink.net
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II / antagonists & inhibitors*,  physiology
Heart Failure / etiology
Humans
Hypertension / drug therapy*
Hypertrophy, Left Ventricular / etiology
Managed Care Programs*
Renin-Angiotensin System / physiology
Chemical
Reg. No./Substance:
11128-99-7/Angiotensin II

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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