ANGIOTENSIN-II RECEPTOR ANTAGONISTS - CLINICAL DEVELOPMENT AND FUTUREPERSPECTIVES

Blockade of the renin-angiotensin system with angiotensin-converting e nzyme (ACE) inhibitors is now recognized as an effective approach for the treatment of hypertension and congestive heart failure. In additio n, ACE inhibitors are very effective for the prevention of chronic ren al failure. Today, it is possible to antagonize the effects of angiote nsin II more specifically using AT(1) receptor antagonists. Several no n-peptide, orally active angiotensin II receptor antagonists have rece ntly been developed clinically. These new molecules are as effective a s ACE inhibitors, calcium antagonists and beta-blockers at reducing bl ood pressure in hypertensive patients. Furthermore, they appear to hav e similar systemic and renal hemodynamic properties in patients with c ongestive heart failure and renal diseases. Now, several large clinica l trials such as the LIFE, the RENAAL and the ELITE II studies are und er way to investigate the long-term benefits of one of these compounds in hypertension, heart failure and type II diabetic nephropathy.