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For a simple overview of the development of ARBs, see figure 3. Because of saralasin, the first Ang II antagonist, and the development of the first ACE inhibitor captopril, it was generally acknowledged that Ang II receptor antagonists might be promising as effective antihypertensive agents. [2] [7]
This led to the development of captopril, the first ACE inhibitor. When the adverse effects of captopril became apparent new derivates were designed. Then after the discovery of two active sites of ACE: N-domain and C-domain, the development of domain-specific ACE inhibitors began. [1] [2]
The choice between the drugs is to a large degree determined by the characteristics of the patient being prescribed for, the drugs' side effects, and cost. Most drugs have other uses; sometimes the presence of other symptoms can warrant the use of one particular antihypertensive. Examples include: Age can affect the choice of medications.
Antihypertensive drug use during pregnancy is relatively common and increasing. [32] Only a small proportion of available antihypertensive drugs have been tested in pregnant women, and many are contraindicated. [citation needed] It is important to make the exposure of medications to the baby as small as possible. [30]
Zilebesiran is an experimental small interfering RNA developed by Roche and Alnylam that is administered subcutaneously twice annually to lower blood pressure in people already taking other antihypertensive drugs. [1] [2] [3] It works by impeding the synthesis of angiotensinogen in the liver. [4] [5]
Moxonidine is a new-generation alpha-2/imidazoline receptor agonist antihypertensive drug licensed for the treatment of mild to moderate essential hypertension. [5] [6] It may have a role when thiazides, beta-blockers, ACE inhibitors, and calcium channel blockers are not appropriate or have failed to control blood pressure.
Antihypertensive agents comprise multiple classes of compounds that are intended to manage hypertension (high blood pressure). Antihypertensive therapy aims to maintain a blood pressure goal of <140/90 mmHg in all patients, as well as to prevent the progression or recurrence of cardiovascular diseases (CVD) in hypertensive patients with established CVD. [2]
It is used to treat hypertension as monotherapy or in combination with other antihypertensive agents. [7] [39] The key to the discovery of aliskiren was crystallography and molecular modeling techniques. Now, a solution has been found to the problem that impeded the development of the renin inhibitors of the previous generations.
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