Effects of angiotensin II receptor blockers on the course of the disease in patients with stable ischemic heart disease
https://doi.org/10.17802/2306-1278-2022-11-1-124-134
Abstract
Highlights. The review synthesizes the results of clinical studies on the use of sartans. This topic is highly relevant due to the antihypertensive, metabolic and organ-protective effect of sartans, which can positively affect the course of coronary atherosclerosis.
Abstract. Angiotensin II receptor blockers (sartans) are widely used to treat cardiovascular diseases. This class of drugs has antihypertensive and metabolic effects and organ-protective capabilities. Currently, sartans are of high interest due to their pleiotropic effect: improved lipid metabolism, antidiabetogenic action, nephroprotection, and, as a result, reduced total cardiovascular risk. The article presents an overview of clinical data on the use of sartans in patients with ischemic heart disease, the mechanisms of organ-protective effects and prospects of using this class of drugs for total cardiovascular risk reduction. The following data sources were used: e-Library, ClinicalTrials.gov, PubMed, trialbulletin.com, smartpatients.com, BioPortfolio.com.
About the Authors
A. M. Kochergina
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests:
Russian Federation
Anastasia M. Kochergina - M.D., Ph.D., Researcher at the Laboratory of Circulatory Pathology, Department of Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases.
6, Sosnoviy blvd., Kemerovo, 650002.
Competing Interests:
No
N. A. Kochergin
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests:
Russian Federation
Nikita A. Kochergin - MD, PhD, Researcher at the Laboratory of Interventional and Reconstructive Cardiovascular Surgery, Department of Cardiovascular Surgery, Research Institute for Complex Issues of Cardiovascular Diseases.
6, Sosnoviy blvd., Kemerovo, 650002.
Competing Interests:
No
References
1. Kareva E.N. The evolution of sartans, or are all sartans the same? Klinicheskaja farmakologija i terapija. 2016; 25(3): 11-21. (In Russian)
2. Martynyuk T.V., Chazova I.E. The role of the angiotensin receptors blocker telmisartan in the treatment of arterial hypertension. Kardiologicheskij Vestnik. 2017; (3): 76-82. (In Russian)
3. Dahlof B., Devereux R.B., Kjeldsen S.E., Julius S., Beevers G., de Faire U., Fyhrquist F., Ibsen H., Kristiansson K., Lederballe-Pedersen O., Lindholm L.H., Nieminen M.S., Omvik P., Oparil S., Wedel H.; LIFE Study Group. et al. Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet. 2002; 359(9311): 995-1003. doi:10.1016/S0140-6736(02)08089-3.
4. Montalescot G., Sechtem U., Achenbach S., Andreotti F., Arden C., Budaj A. et al. 2013 ESC guidelines on the management of stable coronary artery. Eur Heart J. 2013; 34: 2949-3003. doi: 10.1093/eurheartj/eht296.
5. Kosarev V.V., Babanov S.A. Features of the clinical pharmacology of sartans. Russian Medical Journal. 2012; 20(28): 1427-1432. (In Russian)
6. Schwalm J.D., McCready T., Lopez-Jaramillo P., Yusoff K., Attaran A., Lamelas P., Camacho PA, Majid F, Bangdiwala SI, Thabane L, Islam S, McKee M, Yusuf S. A communitybased comprehensive intervention to reduce cardiovascular risk in hypertension (HOPE 4): a cluster-randomised controlled trial. Lancet. 2019; 394(10205): 1231-1242. doi: 10.1016/S0140-6736(19)31949-X.
7. Fox K.M. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomased, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet. 2003; 362(9386); 782-788. doi:10.1016/s0140-6736(03)14286-9.
8. Bots M.L., Remme W.J., Luscher T.F., Fox K.M., Bertrand M., Ferrari R., Simoons ML, Grobbee DE; EUROPA-PERFECT Investigators. ACE inhibition and endothelial function: main findings of PERFECT, a sub-study of the EUROPA trial. Cardiovasc Drugs Ther. 2007; 21(4): 269-279. doi:10.1007/s10557-007-6041-3.
9. ONTARGET Investigators,Yusuf S., Teo K.K., Pogue J., Dyal L., Copland I., Schumacher H., Dagenais G., Sleight P., Anderson C. Telmisartan, ramipril or both in patients at high risk for vascular events. N Engl J Med. 2008; 358(15): 15471559. doi: 10.1056/NEJMoa0801317.
10. Suzuki T., Nozawa T., Fujii N., Sobajima M., Ohori T., Shida T., Matsuki A., Kameyama T., Inoue H.. Combination therapy of candesartan with statin inhibits progression of atherosclerosis more than statin alone in patients with coronary artery disease. Coron Artery Dis. 2011; 22(5): 352-335. doi: 10.1097/MCA.0b013e328346b8a2.
11. Dzhaiani N.A. Candesartan in cardiology practice. Medical Council. 2017; (7): 12-16. (In Russian). doi: 10.21518/2079-701X-2017-7-12-16.
12. Belyalov F.I. Ischemic heart disease and renal dysfunction. Rational Pharmacotherapy in Cardiology. 2017; 13(3): 409-415. (In Russian). doi: 10.20996/1819-6446-2017-13-3-409-415.
13. Nurmatov Sh.I., Zokirov F.K., Kurbanov B.V., Gumanova K.S., Belous A.A. Microalbuminuria as an early diagnostic, clinical and prognostic marker in hypertension. Colloquium-journal. 2019; 16-5 (40): 36-40. (In Russian)
14. Leonova M.V. Clinical pharmacology of angiotensin II receptor blockers: valsartan. Medical Council. 2014; 17: 66-71. (in Russian)
15. Kunz R., Friedrich C., Wolbers M., Mann J.F.E. Metaanalysis: effect of monotherapy and combination therapy with inhibitors of the renin-angiotensin system on proteinuria in renal disease. Ann Intern Med. 2008, 148(1): 30-48. doi:10.7326/0003-4819-148-1-200801010-00190.
16. Sarafidis P.A., Stafylas P.C., Kanaki A.I., Lasaridis A.N. Effects of renin-angiotensin system blockers on renal outcomes and all-cause mortality in patients with diabetic nephropathy: an updated meta-analysis. Am J Hypertens. 2008; 21(8): 922929. doi: 10.1038/ajh.2008.206.
17. Viberti G., Wheeldon N.M. Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus: a blood pressure-independent effect. Circulation 2002; 106(6): 672678. doi:10.1161/01.cir.0000024416.33113.0a.
18. Brenner B.M., Cooper M.E., de Zeeuw D., Keane W.F., Mitch W.E., Parving H.H., Remuzzi G., Snapinn S.M., Zhang Z., Shahinfar S.; RENAAL Study Investigators. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001; 345(12): 861-869. doi: 10.1056/NEJMoa011161.
19. Uzu T., Sawaguchi M., Maegawa H., Kashiwagi A. Reduction of microalbuminuria in patients with type 2 diabetes. Diabetes Care. 2007; 30(6): 1581-1583. doi:10.2337/dc06-2493.
20. Kirichenko A.A. Sartans and the problem of comorbidity. Russian Medical Journal. 2018; 26(1-2): 110-114. (in Russian)
21. Andersen S., Brochner-Mortensen J., Parving H.H. Kidney function during and after withdrawal of long-term irbesartan treatment in patients with type 2 diabetes and microalbuminuria. Diabetes Care. 2003; 26(12): 3296-302. doi:10.2337/diacare.26.12.3296.
22. Haller H., Ito S., Izzo J.L., Januszewicz A., Katayama S. Menne J., Mimran A., Rabelink T.J., Ritz E., Ruilope L.M., Rump L.C., Viberti G.; ROADMAP Trial Investigators. Olmesartan for the delay or prevention of microalbuminuria in type 2 diabetes. N Engl J Med. 2011; 364(10): 907-917. doi: 10.1056/NEJMoa1007994.
23. Artham S., Fouda A.Y., El-Remessy A.B., Fagan S.C. Vascular protective effects of angiotensin receptor blockers: beyond blood pressure. Receptors Clin Investig. 2015; 2(3): e774. doi:10.14800/rci.774.
24. BoschA.J., Harazny J.M., Kistner I., Friedrich S., Wojtkiewicz J., Schmieder R.E. Retinal capillary rarefaction in patients with untreated mild-moderate hypertension. BMC Cardiovasc Disord. 2017; 17(1): 300. doi: 10.1186/s12872-017-0732-x.
25. Priya M.K., Sahu G., Soto-Pantoja D.R., Goldy N., Sundaresan A.M., Jadhav V., Barathkumar T.R., Saran U., Jaffar Ali B.M., Roberts D.D., Bera A.K., Chatterjee S. Tipping off endothelial tubes: nitric oxide drives tip cells. Angiogenesis. 2015; 18(2): 175-189. doi: 10.1007/s10456-014-9455-0.
26. Matsumoto S., Shimabukuro M., Fukuda D., Soeki T., Yamakawa K., Masuzaki H., Sata M. Azilsartan, an angiotensin II type 1 receptor blocker, restores endothelial function by reducing vascular inflammation and by increasing the phosphorylation ratio Ser(1177)/Thr(497) of endothelial nitric oxide synthase in diabetic mice. Cardiovasc Diabetol. 2014; 13: 30. doi: 10.1186/1475-2840-13-30.
27. Ishrat T., Pillai B., Soliman S., Fouda A.Y., Kozak A., Johnson M.H., Ergul A., Fagan S.C. Low-dose candesartan enhances molecular mediators of neuroplasticity and subsequent functional recovery after ischemic stroke in rats. Mol Neurobiol. 2015; 51(3): 1542-1553. doi: 10.1007/s12035-014-8830-6.
28. Soliman S., Ishrat T., Pillai A., Somanath P.R., Ergul A., El-Remessy A.B., Fagan S.C. Candesartan induces a prolonged proangiogenic effect and augments endothelium-mediated neuroprotection after oxygen and glucose deprivation: role of vascular endothelial growth factors A and B. J Pharmacol Exp Ther. 2014; 349(3): 444-457. doi: 10.1124/jpet.113.212613.
29. Miller A.G., Tan G., Binger K.J., Pickering R.J., Thomas M.C., Nagaraj R.H., Cooper M.E., Wilkinson-Berka J.L.Candesartan attenuates diabetic retinal vascular pathology by restoring glyoxalase-I function. Diabetes. 2010; 59(12): 3208-3215. doi: 10.2337/db10-0552.
30. Barauna V.G., Mantuan P.R., Magalhaes F.C., Campos L.C., Krieger J.E. AT1 receptor blocker potentiates shear-stress induced nitric oxide production via modulation of eNOS phosphorylation of residues Thr(495) and Ser(1177). Biochem Biophys Res Commun. 2013; 441(4): 713-719. doi: 10.1016/j.bbrc.2013.10.108.
31. Koike A., Minamiguchi I., Fujimori K., Amano F. Nitric oxide is an important regulator of heme oxygenase-1 expression in the lipopolysaccharide and interferon-gamma-treated murine macrophage-like cell line J774.1/JA-4. Biol Pharm Bull. 2015; 38(1): 7-16. doi: 10.1248/bpb.b14-00405.
32. Shanab A.Y., Elshaer S.L., El-Azab M.F., Soliman S., Sabbineni H., Matragoon S., Fagan S.C., El-Remessy A.B. Candesartan stimulates reparative angiogenesis in ischemic retinopathy model: role of hemeoxygenase-1 (HO-1). Angiogenesis. 2015; 18(2): 137-150. doi: 10.1007/s10456-014-9451-4.
33. Barbarash O.L., Usoltseva E.N., Kashtalap V.V., Kolomytseva I.S., Sizova I.N., Volykova M.A., Shibanova I.A.The Role of subclinical inflammation in progression of multifocal atherosclerosis during one year after myocardial infarction. Kardiologiia. 2014; 54(80: 19-25. (in Russian) doI: 10.18565/cardio.2014.8.19-25
34. Derosa G., Cicero A.F., Carbone A., Querci F., Fogari E., D'Angelo A., Maffioli P. Different aspects of sartan + calcium antagonist association compared to the single therapy on inflammation and metabolic parameters in hypertensive patients. Inflammation. 2014; 37(1): 154-162. doi: 10.1007/s10753-013-9724-x.
35. Evdokimova A.G., Lozhkina M.V., Kovalenko E.V. Key features of candesartan application in clinical practice. Consilium Medicum. 2016; 18(1): 54-59. (in Russian). https://doi.org/10.26442/2075-1753_2016.1.54-59
36. Nedogoda S.V., Chumachek E.V., Tsoma V.V., Salasyuk A.S., Smirnova V.O., Popova E.A. Effectiveness of in insulin resistance correction and the adipokines level reduction in patients with arterial hypertension in comparison with other ARBS. Russian Journal of Cardiology. 2019; 24(1): 70-79. (in Russian). http://dx.doi.org/10.15829/1560-4071-2019-1-70-79.
37. Murakami K., Wada J., Ogawa D., Horiguchi C.S., Miyoshi T., Sasaki M., Uchida H.A., Nakamura Y., Makino H. The effects of telmisartan treatment on the abdominal fat depot in patients with metabolic syndrome and essential hypertension: Abdominal fat Depot Intervention Program of Okayama (ADIPO). Diab Vasc Dis Res. 2013; 10(1): 93-96. doi: 10.1177/1479164112444640.
38. Podzolkov V.I., Pisarev M.V. Angiotensin receptor blockers with pleiotropic properties: a new standard in cardiovascular risk management and treatment of hypertension. Rational Pharmacotherapy in Cardiology. 2017; 13(3): 383-390. (in Russian). doi: 10.20996/1819-6446-2017-13-3-383-390.
39. Kochergina A.M., Khorlampenko A.A. Percutaneous coronary intervention for patients with type 2 diabetes mellitus: risks and novel way to manage. Diabetes Mellitus. 2019; 22(2): 151-158. (in Russian). doi: 10.14341/DM9827.
40. Nomura S., Shouzu A., Omoto S., Nishikawa M., Fukuhara S., Iwasaka T. Effect of valsartan on monocyte/ endothelial cell activation markers and adiponectin in hypertensive patients with type 2 diabetes mellitus. Thromb Res. 2006; 117(4): 385-392. doi:10.1016/j.thromres.2005.04.008.
41. Mori Y., Itho Y., Tajima N. Telmisartan improves lipid metabolism and adiponectin production but does not affect glycemic control in hypertensive patients with type 2 diabetes. Adv Ther. 2007; 24(1): 146-153. doi:10.1007/bf02850002.
42. Karpov Yu.A., Melekhov A.V. Candesartan: going beyond cardiovascular continuum. Atmosphere. Cardiology News. 2019; (2): 31-40. (in Russian)
43. Rizos C.V., Milionis H.J., Kostapanos M.S., Florentin M., Kostara C.E., Elisaf M.S., Liberopoulos E.N. Effects of rosuvastatin combined with olmesartan, irbesartan, or telmisartan on indices of glucose metabolism in Greek adults with impaired fasting glucose, hypertension, and mixed hyperlipidemia: a 24week, randomized, open-label, prospectivestudy. Clin Ther. 2010; 32(3): 492-505. doi: 10.1016/j.clinthera.2010.03.018.
44. Ostroumova O.D., Kochetkov A.I. Antihypertensive and target-organ protective properties of telmisartan and hydrochlorothiazide single-pill combination. Rational Pharmacotherapy in Cardiology. 2019; 15(4): 558-567. (in Russian). doi: 10.20996/1819-6446-2019-15-4-558-567.
45. Rawish E., Nickel L., Schuster F., Stoelting I., Frydrychowicz A., Saar K., Hubner N., Othman A., Kuerschner L., Raasch W. Telmisartan prevents development of obesity and normalizes hypothalamic lipid droplets. J Endocrinol. 2020; 244(1): 95-110. doi: 10.1530/JOE-19-0319.
46. Schuster F., Huber G., Stolting I., Wing E.E., Saar K., Hubner N., Banks W.A., Raasch W. Telmisartan prevents diet-induced obesity and preserves leptin transport across the bloodbrain barrier in high-fat diet-fed mice. Pflugers Arch. 2018; 470(11): 1673-1689. doi: 10.1007/s00424-018-2178-0.
47. Dhiman N., Awasthi R., Jindal S., Khatri S., Dua K. Development of bilayer tablets with modified release of selected incompatible drugs. Polim Med. 2016; 46(1): 5-15. doi: 10.17219/pim/62511.
48. Liu Z., Zhao Y., Wei F., Ye L., Lu F., Zhang H., Diao Y., Song H., Qi Z. Treatment with telmisartan/rosuvastatin combination has a beneficial synergistic effect on ameliorating Th17/Treg functional imbalance in hypertensive patients with carotid atherosclerosis. Atherosclerosis. 2014; 233(1): 291-299. doi:10.1016/j.atherosclerosis.2013.12.004.
49. Svistunov A.A., Osadchuk M.A., Balashov D.V., Osadchuk M.M. A differentiated approach to the appointment of sartans for arterial hypertension and its associated diseases. Moscow: RAMN Publ.; 2017. 72 s. (In Russian)
50. Trukhan D.I. Angiotensin II receptor blockers in the treatment of arterial hypertension in patients with concomitant pathology: focus on candesartan. Systemic Hypertension. 2014; 11(3): 24-29. (In Russian). https://doi.org/10.26442/2075-082x_11.3.24-29.
Review
For citations:
Kochergina A.M., Kochergin N.A. Effects of angiotensin II receptor blockers on the course of the disease in patients with stable ischemic heart disease. Complex Issues of Cardiovascular Diseases. 2022;11(1):124-134. (In Russ.) https://doi.org/10.17802/2306-1278-2022-11-1-124-134
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