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A New Therapeutic Principle

Franz H. Messerli, MD; Michael A. Weber, MD; Hans R. Brunner, MD

Arch Intern Med. 1996;156(17):1957-1965.

Abstract
Angiotensin II receptor antagonists represent a new class of drugs that provide a sitespecific blockade of the effects of angiotensin II. Losartan potassium, the first compound of this drug class, has recently become available in the United States. The clinical experience with angiotensin II receptor antagonists has demonstrated that these drugs are safe and efficacious for the treatment of hypertension and, possibly, congestive heart failure. Unlike with angiotensin-converting enzyme inhibitors, the incidence of cough observed with angiotensin receptor antagonists is similar to that with placebo. Although several angiotensin receptors have been characterized, the effects of losartan and other angiotensin receptor antagonists under development are selective for the angiotensin II type 1 receptor. Unlike angiotensinconverting enzyme inhibitors, angiotensin receptor antagonists do not inhibit bradykinin metabolism or enhance prostaglandin synthesis. The antihypertensive efficacy of the angiotensin receptor antagonists has been documented to be similar to that of angiotensin-converting enzyme inhibitors. If the findings of clinical studies corroborate the initial reports on efficacy and safety, it seems likely that the angiotensin receptor antagonists will be added to the list of drugs that have been deemed suitable for first-line therapy in the treatment of hypertension and congestive heart failure.

Arch Intern Med. 1996;156:1957-1965

Author Affiliations
From the Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, La (Dr Messerli), the Hypertension Center, Veterans Affairs Medical Center, Long Beach, Calif (Dr Weber), and the Division of Hypertension, Department of Medicine, Centre des Hôpitaux Universitaires Vaudois, Lausanne, Switzerland (Dr Brunner).

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