新一代抗高血压药——氯沙坦的临床应用

Losartan--A New Class of Antihypertensive Drugs Applied in Clinical Practice

氯沙坦是第一个应用 于临床的血管紧张素Ⅱ受体(AT1亚型)拮抗剂。在轻/中度高血压病人,氯沙坦作为每日口服一次的抗高血压药物与依那普利,安替洛尔,非洛地平缓释剂的疗效相似。氯沙坦的耐受性良好,头晕是被报道的唯一与药物相关的不良反应,咳嗽的发生率明显少于转换酶抑制剂。氯沙坦增加尿酸排泄和降低血尿酸水平的临床意义有待进一步观察。氯沙坦是否能减少心血管事件,预防和逆转左心室肥厚、动脉硬化和肾功能衰竭的大规模临床试验正在进行中。

Losartan is the first of a new class of orally active antihypertensive drugs which antagonise the action of angiotensin (AT) II at the AT1 receptor subtype. Losartan is effective as a once-daily antihypertensive agent. In mild and moderate hypertension, losartan has similar efficacy to enalapril. atenolol and felodipine extended release. Losartan is well tolerated in hypertensive patients, with dizziness being reported as the only drug-related adverse effect. The incidence of cough in losartan is less than that of the angiotensin converting enzyme inhibitor. The therapeutic importance of losartan increasing uric acid secretion and fowering plasma uric acid Ievels is under investigation. Several large scale of clinical trials are ongoing on whether losartan reduces cardiovascular events, prevents or causes regression of end-organ damage such as left ventricular hypertrophy, atheroscerosis and renal failure.