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Although evidence shows calcium channel blockers and thiazide-type diuretics are preferred first-line treatments for most people (due to both efficacy and cost), an angiotensin II receptor antagonist such as losartan is recommended as first-line treatment in people under the age of 55 who cannot tolerate an ACE inhibitor. [15]
Losartan, the first ARB. Angiotensin II receptor blockers (ARBs), formally angiotensin II receptor type 1 (AT 1) antagonists, [1] also known as angiotensin receptor blockers, [2] [3] angiotensin II receptor antagonists, or AT 1 receptor antagonists, are a group of pharmaceuticals that bind to and inhibit the angiotensin II receptor type 1 (AT 1) and thereby block the arteriolar contraction and ...
There are many classes of antihypertensives, which lower blood pressure by different means. Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers or antagonists (ARBs), and beta blockers.
Antihypertensive agents are classified according to their mechanism of actions. The most common classes prescribed are diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), calcium channel blockers (CCBs) and beta-blockers. Antihyperlipidemic agents most often prescribed are statins, ezetimibe and ...
Losartan, valsartan, candesartan, irbesartan, telmisartan and olmesartan all contain a biphenyl-methyl group. Losartan is partly metabolized to its 5-carboxylic acid metabolite EXP 3174, which is a more potent AT 1 receptor antagonist than its parent compound [17] and has been a model for the continuing development of several other ARBs. [1]
Angiotensin-converting-enzyme inhibitors (ACE inhibitors) are a class of medication used primarily for the treatment of high blood pressure and heart failure. [1] [2] This class of medicine works by causing relaxation of blood vessels as well as a decrease in blood volume, which leads to lower blood pressure and decreased oxygen demand from the heart.
Beta blockers vary in their lipophilicity (fat solubility) and in turn in their ability to cross the blood–brain barrier and exert effects in the central nervous system. [76] Beta blockers with greater blood–brain barrier permeability can have both neuropsychiatric therapeutic benefits and side effects, as well as adverse cognitive effects ...
Importantly, the combination of valsartan and ACE inhibitors has not shown morbidity or mortality benefits but rather increases mortality risk when added to combination beta blocker and ACE inhibitor therapy, and increases the risk of adverse events like hyperkalaemia, hypotension and renal failure.
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