Efficacy and Tolerability of Candesartan Cilexetil Monotherapy or in Combination with Other Antihypertensive Drugs

Schulte, K.-L.; Fischer, Martin; Lenz, Tomas; Meyer‐Sabellek, W.

doi:10.2165/00044011-199918060-00004

Cited by 20 publications

(15 citation statements)

References 11 publications

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“…In previous open-label observational studies with ARBs in the primary-care setting, the respective rates had been considerably higher [36,37]. Interestingly, the rate did not differ significantly on comparison of the respective monotherapies or combination therapies with HCTZ.…”

Section: Discussionmentioning

confidence: 82%

Irbesartan for the treatment of hypertension in patients with the metabolic syndrome: A sub analysis of the Treat to Target post authorization survey. Prospective observational, two armed study in 14,200 patients

Kintscher

Bramlage

Paar

et al. 2007

Cardiovasc Diabetol

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Section: Discussionmentioning

confidence: 82%

Irbesartan for the treatment of hypertension in patients with the metabolic syndrome: A sub analysis of the Treat to Target post authorization survey. Prospective observational, two armed study in 14,200 patients

Kintscher

Bramlage

Paar

et al. 2007

Cardiovasc Diabetol

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“…QOL is one of the important targets to be improved in the treatment of hypertension, and the QOL-guided treatment may improve the patients' psychological status and improve compliance to antihypertensive agents. Numerous studies have demonstrated that antihypertensive treatments improve patient's QOL (7)(8)(9)(10), and beneficial effects of candesartan are also evident (11)(12)(13)(14). Basically the improvement of patients' QOL seems to depend on blood pressure-lowering effects (10).…”

Section: Discussionmentioning

confidence: 99%

Effects of Candesartan for Middle-Aged and Elderly Women with Hypertension and Menopausal-Like Symptoms

Ikeda¹,

Inoue

Uemura³

et al. 2006

Hypertens Res

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Hypertension in middle-aged or elderly women is often accompanied with various symptoms, which may be related to climacteric. The symptoms of post-menopausal women are suggested to be derived in part from instability of the sympathetic nerve system due to a low estrogen state. An angiotensin-receptor blocker, candesartan cilexetil (candesartan), is known to suppress sympathetic nerve activity by inhibiting the reninangiotensin system in the brain, suggesting that it may be effective for ameliorating these symptoms. The

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“…Preliminary studies in sodium-depleted healthy volunteers and in patients with diabetes and normal renal function recorded greater reduction in BP and greater increases in plasma rennin activity after the addition of losartan to enalapril treatment than after doubling the dosage of enalapril (20). Two large, open-label, clinical trials indicated that when an AT1 blocker is added to patients who are receiving an ACEI, the same degree of BP reduction is attained as when adding an AT1 blocker to other classes of drug, such as ␤ blockers, calcium-channel blockers, or even diuretics (21,22).…”

Section: Combined Treatment With Acei and Arbmentioning

confidence: 99%

Dual Blockade of the Renin-Angiotensin System in the Progression of Renal Disease

Fernández-Juárez¹,

Barrio²,

Vinuesa³

et al. 2006

Journal of the American Society of Nephrology

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There is clear evidence that pharmacologic blockade of the renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) reduces proteinuria and slows the progression of renal disease in diabetic and nondiabetic nephropathies, a beneficial effect that is not related to BP control. Some patients exhibit a significant beneficial response, whereas others do not. The absence of response may be explained by the incomplete blockade of the RAS obtained with ACEI. In the search of new alternatives that could improve the antiproteinuric and nephroprotective effects of RAS blockers, the association of ACEI and ARB might prove useful. ARB produces a complete blockade of the RAS. Several studies have shown a more marked antiproteinuric effect of the dual blockade of the RAS versus ACEI or ARB alone. A recent study also demonstrated that this more marked antiproteinuric effect is associated with less progression of renal disease in primary nondiabetic nephropathies despite a similar effect on BP. Until now, there has not been any reference to a beneficial effect on progression of the dual blockade in type 2 diabetic nephropathy, which is the most frequent cause of ESRD. A multicenter, prospective, open, active-controlled, and parallel-group trial was designed to compare the effects of an ACE inhibitor versus an ARB or its combination on renal disease progression, proteinuria, and cardiovascular events in type 2 diabetic nephropathy. S ingle-nephron hyperfiltration hypothesis, put forward by Brenner more than 20 yr ago, helped to explain the inexorable decline in renal function that is observed in chronic renal disease once the initial insult has disappeared. Angiotensin II is responsible for the increase in glomerular hydraulic capillary pressure by means of increasing systemic BP along with vasoconstriction of the efferent arteriole, thereby increasing filtration pressure in glomerular capillary walls. In experimental rat models with renal disease, a decrease of similar magnitude in systemic BP can be achieved either with angiotensin-converting enzyme inhibitors (ACEI) or with a combination of diuretics, reserpine and hydralazine, although only in those who are treated with ACEI is a reduction in glomerular capillary pressure and in progression of renal disease observed (1). J Am Soc NephrolBesides these hemodynamic changes, many other experimental models of renal damage that result in severe proteinuria (e.g., nephrosis by adriamycin or immune-complex glomerulonephritis [2,3]) have implicated angiotensin as a mediator in most of the inflammatory mechanisms that are involved in the progression of chronic renal disease. In proteinuric nephropathies, protein trafficking through proximal tubular cells, besides damaging this tubular segment, stimulates the production of NF-B, in part induced by angiotensin (4). NF-B is present in all cellular types and plays a crucial role in inflammation and apoptosis. In experimental models of nephritis, activation of NF-B results i...

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Efficacy and Tolerability of Candesartan Cilexetil Monotherapy or in Combination with Other Antihypertensive Drugs

Cited by 20 publications

References 11 publications

Irbesartan for the treatment of hypertension in patients with the metabolic syndrome: A sub analysis of the Treat to Target post authorization survey. Prospective observational, two armed study in 14,200 patients

Irbesartan for the treatment of hypertension in patients with the metabolic syndrome: A sub analysis of the Treat to Target post authorization survey. Prospective observational, two armed study in 14,200 patients

Effects of Candesartan for Middle-Aged and Elderly Women with Hypertension and Menopausal-Like Symptoms

Dual Blockade of the Renin-Angiotensin System in the Progression of Renal Disease

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