New sarts. Sartans: action, use, list of drugs, indications and contraindications. Ramilong is a long acting ACE inhibitor.

Sartans are called special agents, the action of which is directed to angiotensin II receptor blockers. Often doctors prescribe them to patients suffering from hypertension, since with the help of these medicines it is possible to improve the condition of the pathology.

Impact principle

During the process of lowering pressure in the kidneys, an oxygen deficiency is formed, as a result of which renin is produced. It is with its help that angiotensin I appears, which is converted to angiotensin II. This substance is considered to be an active component that has an effect on pressure, increasing it. Therefore, taking sartans, if the patient has it, helps to influence the receptors, which prevents hypertension.

Advantages

It is believed that the most effective drugs for hypertension are sartans, they have a number of advantages:

• there is no dependence on long-term use;
• with normal blood pressure, drugs do not reduce it;
• well tolerated and have a minimum of negative effects.

Also, drugs improve renal functioning in diabetic nephropathy, guarantee regression of ventricular hypertrophy of the heart and normalize indicators in heart failure.

To achieve maximum effectiveness, scientists recommend using diuretics simultaneously with angiotensin II. For example, "Indapamide" and "Dichlothiazide". Experts note that if you follow this rule, you can increase the effectiveness by 1.5 times. Thanks to this, not only the effect is enhanced, but the work of the drugs is also prolonged.

Additional effects of these medicines:

1. Provides protection to the cells of the nervous system. The drug minimizes the adverse effects of the disease on the brain, being a prophylactic against stroke. Because they affect the brain, doctors often prescribe them to patients who have normal blood pressure but are at risk for vascular disease.
2. The threat of atrial fibrillation paroxysm is reduced, which is ensured with the help of antiarrhythmic effects.
3. Reduces the risk of diabetes. The metabolic effect is responsible for this, and in the presence of this disease, the patient's condition will return to normal, as insulin resistance of tissues is carried out.

Important! Such substances during hypertension normalize lipid metabolism, reduce cholesterol, as well as triglycerides, the volume of uric acid. All this is very important when taking diuretics.

Some sartans are beneficial for Marfan syndrome, they strengthen blood vessels and prevent their possible rupture. The muscle condition is also normalized. Such an effect has "Losartan".

Indications

Medical experts prescribe sartans for people who have:

1. , which is the main indicator for their use.
2. Heart failure, which can develop against the background of overactive activity of the renin-angiotensin-aldosterone system. At an early stage, it allows to normalize cardiac function.
3. Nephropathy is a dangerous consequence of diabetes, arterial hypertension. With the disease, there is a decrease in the amount of proteins excreted in the urine. Medicines help slow down the development of kidney failure.

Such drugs do not affect metabolism, bronchial patency, organs of vision. In rare cases, they can cause a dry cough, an increase in potassium levels. The effect of the use of medicines will be visible in a month.

Peculiarities

Self-treatment with sartans is prohibited, the treatment regimen should be selected by the doctor individually for each patient. Before prescribing drugs, a special diagnosis is carried out, and the features of the patient's condition are studied.

Important! Drugs must be taken every day, without interruption.

Doctors often prescribe a combination of sartans and diuretics. The most well-known drugs for the treatment of hypertension are:

These substances are also responsible for the protection of internal organs, they are safe, as they do not have side effects.

Classification of drugs

The cost of drugs depends on the manufacturer, duration of action. When using the cheapest medicines, the patient must understand that they need to be drunk more often, since they have a short effect.

Drugs are divided according to composition and effect. Doctors divide them into prodrugs and active substances, based on the presence of an active metabolite. According to the chemical composition, sartans are:

Without a prescription, all these funds can be purchased at specialized points. In addition, pharmacies offer ready-made combinations.

Effect on organs

When using sartans, the patient does not experience an increase in the number of heart contractions, which helps prevent the formation of vascular and cardiac hypertrophy. This is a very important point in case of cardiosclerosis, and also when there is hypertensive cardiomyopathy.

As for the effect on the kidneys, since the disease affects this organ, taking sartans can help with this. This is done by affecting the protein excretion in the urine, namely the drug helps to minimize the level of these substances. But you should be aware that drugs usually increase plasma creatine, which leads to an acute form of the disease.

Contraindications

Sartans for arterial hypertension most often do not cause an adverse reaction, but sometimes patients may notice such problems:

• dizziness;
• the appearance of sharp pains in the head;
• sleep is disturbed;
• the temperature increases;
• nausea accompanied by vomiting;
• constipation or diarrhea;
• itching occurs.

Therapy should take place only under the supervision of the attending physician. It is forbidden to take medications during childbearing and breastfeeding, they should not be given to children. With great care, the use of medicines by patients suffering from, as well as elderly people, is allowed.

The doctor selects the dosage for the patient individually, which is guaranteed to quickly lead to a good result that lasts for a long time.

Scientists conducted a large number of experiments to prove the effectiveness of the funds. The people who agreed to take part in the experiments helped to study in practice all the mechanisms of the sartans.

A study is currently underway to test whether drugs can actually cause cancer. These are necessary procedures, as some experts express an opinion about the involvement of sartans in provoking various tumors. They explain this by the fact that the drugs, when they enter the body, cause a certain process of certain substances, which, in turn, plays an important role in regulating cell proliferation, which leads to a terrible disease.

Previous experiments have shown that people forced to use sartans have a high risk of developing a tumor. Despite this, the risk of death from oncology is present in the person who takes the drug, and in the one who has never even heard of it.

Modern medicine cannot yet unequivocally answer this question. The reason for this is the lack of complete information about the involvement of various medications in the disease. Despite this, the funds are considered the best in the fight against hypertension.

Sartans, angiotensin II receptor antagonists: what is it, how do the drugs work, a list of the best representatives, contraindications

Sartans are a class of antihypertensive drugs that reduce the sensitivity of receptors in the vessel wall, heart to the hormone angiotensin 2, which stimulates their contraction. This is one of the youngest groups of drugs that lower blood pressure. It was created as an alternative to ACE inhibitors, whose use is often accompanied by a complication - dry cough.

Consider the mechanism of action of sartans, the classification of ARBs, the main indications, contraindications, adverse reactions, features of drug interactions.

pharmachologic effect

One of the main systems that regulate blood pressure (BP), the total volume of circulating blood, is called renin-angiotensin-aldosterone (RAAS). This is a complex chain of reactions, interactions of hormones of the liver, kidneys, adrenal glands, which regulates the tone of the vascular wall, the amount of water released. Under the influence of angiotensin-2, the arteries contract, which leads to a narrowing of their lumen, an increase in blood pressure.

Sartans in arterial hypertension (AH) help cells resist the action of the hormone. They block angiotensin-2-sensitive receptors and vascular myocytes begin to ignore its presence.

In addition to the hypotensive effect, ARBs have a number of blood pressure-independent effects, which explains the need for the use of drugs for the treatment of diseases of the heart and kidneys.

Organoprotective, metabolic properties of the sartans group (5)

• reducing the load on the myocardium;
• inhibition, elimination of left ventricular hypertrophy;
• prevention of atrial fibrillation;
• improvement of heart function in chronic organ failure.

• reducing the likelihood of developing a stroke;
• improvement of cognitive functions in patients with arterial hypertension.

• reduction of edema;
• increased potassium levels;
• elimination of protein excretion in the urine (proteinuria);
• slowing the progression of renal failure.

• increased sensitivity of tissues to insulin;
• lowering blood sugar levels;
• inhibition of the development of atherosclerosis;
• reducing the risk of diabetes in patients with hypertension;
• lowering the concentration of triglycerides, total cholesterol, LDL, increasing the content of HDL.

Classification of drugs

The group of sartans is represented by 4 subgroups of different chemical structure.

List of latest generation sartans, drug names

There are two generations of ARBs. Representatives of the first are valsartan, candesartan, losartan, olmesartan, eprosartan, irbesartan. All of them block only one type of receptor (AT-1). Second-generation sartans have two mechanisms of action: they inhibit angiotensin receptors, an activator of peroxisome proliferation y-type (PPAR-y). The latter governs:

• cell differentiation;
• metabolism of lipids, carbohydrates;
• sensitivity of adipose tissue to insulin;
• fatty acid oxidation.

The only second-generation ARB registered in Russia is telmisartan (Micardis). In addition to the properties typical for a group, it is much more efficient:

• prevents the development of atherosclerosis;
• reduces plasma concentration of triglycerides, glucose;
• normalizes the hormonal activity of the pancreas;
• improves metabolic parameters in diabetic patients;
• has an anti-inflammatory effect;
• smoothes some negative reactions from taking thiazide diuretics.

However, sartans differ little in terms of the strength of their effect on blood pressure. The maximum difference in indicators for systolic, diastolic blood pressure is 2 mm Hg. Art. This explains the widespread use of first-generation drugs, including losartan, which was the first to be synthesized.

List of the most effective first generation sartans

• Walz;
• Valsaforce;
• Valsacor;
• Diovan;
• Nortivan;
• Tareg.

• Blocktran;
• Vasotens;
• Zisacar;
• Carsartan;
• Lozap;
• Lorista;
• Renicard.

• Aprovel;
• Ibertan;
• Firmast.

• Angiakand;
• Atakand;
• Hyposart;
• Kandecor;
• Xarten;
• Ordis.

Indications for appointment

Most often, sartans are prescribed as an antihypertensive agent for patients with arterial hypertension. Combining ARBs with other drugs is also effective for:

• chronic heart failure;
• nephropathy;
• microalbuminuria;
• thickening of the wall of the left ventricle;
• diabetes mellitus;
• metabolic syndrome;
• atherosclerosis;
• atrial fibrillation;
• myocardial infarction (only valsartan).

The use of sartans in arterial hypertension

ARBs are first-line antihypertensives and are recommended to be given before other blood pressure-lowering pills. Primary candidates are patients in whom arterial hypertension is accompanied by:

• hypertrophy of the left ventricle or disruption of its work;
• chronic heart failure;
• excretion of albumin in the urine (albuminuria);
• diabetes mellitus;
• impaired renal function (creatinine clearance less than 60 ml / min);
• postinfarction cardiosclerosis;
• chronic renal failure (with intolerance to ACE inhibitors);
• as an alternative to ACE inhibitors, if a cough develops against the background of their use.

All sartans can be prescribed as a separate course, combined with other antihypertensive drugs. Monotherapy is less effective (56-70% success) than complex treatment (80-85% success). The result of taking the drug can not be assessed immediately. The peak of effectiveness falls on 4-8 weeks of therapy.

myocardial infarction

The only drug of the sartans group, which is recommended for patients after myocardial infarction, is valsartan. It is reliably known that it reduces mortality from a heart attack by 25%. A feature of the drug is its high specificity for AT1 receptors, which is 20 times higher than that of losartan (3).

The main advantages of the group

The main advantages of sartans:

• minimum contraindications;
• are slowly excreted from the body: it is enough to take 1 time / day;
• very low chance of developing side effects;
• suitable for diabetics, the elderly, patients with kidney disease;
• do not cause cough;
• increase the life expectancy of patients with cardiovascular diseases;
• reduce the risk of stroke;
• unlike ACE inhibitors do not increase the risk of lung cancer.

Potential Side Effects

The likelihood of developing negative reactions after taking sartans is very small. According to some studies, it is comparable to that of placebo. The most common complication is dizziness, associated with a decrease in pressure. To reduce discomfort, doctors recommend taking the pill at night.

Contraindications

• in case of hypersensitivity to the components of the drug or the active substance;
• during pregnancy, lactation.

Because of their proven adverse effects on the fetus, ARBs are not recommended for women of childbearing age who are not well protected. If an unplanned conception is detected, the drug is stopped.

Also, sartans are prescribed with caution:

• children;
• patients with a decrease in the total volume of circulating blood;
• bilateral stenosis of the renal arteries or narrowing of the artery of a single kidney;
• severe renal failure (creatinine clearance less than 10 ml / min);
• cirrhosis of the liver;
• obstruction of the biliary tract;
• along with drugs that retain potassium.

Possible drug interactions

All sartans are well compatible with other types of drugs. They can be taken together with all known drugs for the treatment of cardiovascular diseases, diabetes. They enhance the hypotensive effect of other types of drugs that lower blood pressure, which must be taken into account when choosing a dose.

Additional monitoring of laboratory blood parameters is required with the combined use of sartans and the following drugs:

Do sartans cause cancer?

In 2010, the results of a large-scale analysis of several clinical studies were published. The authors found a pattern between ARB use and cancer risk. To test the findings of scientists, the US Food and Drug Administration, as well as several independent researchers, conducted their own analysis, which did not reveal a relationship between the use of sartans, an increase in the likelihood of cancerous tumors. Conversely, the use of ARBs reduced the chances of rectal neoplasms.

The question of the relationship between angiotensin receptor inhibitors and oncology has not yet been closed. However, do not be afraid of antihypertensive drugs. Even if the theory is confirmed not in their favor, this risk is extremely small, and the benefit is palpable. To prevent the development of cancer, it will be much more effective to fight other risk factors, rather than stop taking life-prolonging drugs.

Sartans or ACE inhibitors: which is better?

Angiotensin-converting enzyme inhibitors (ACE inhibitors) are very similar in their mechanism of action to angiotensin II receptor blockers. They block the very reaction of converting angiotensin I to angiotensin II.

Later it turned out that this way of hormone formation is not the only possible one. According to a preliminary assessment, the use of sartans should have solved this problem. After all, they inactivate the sensitivity of angiotensin receptors of any origin. This would enhance the hypotensive effect. However, in practice, this assumption was not justified: another type of receptors was found in the body that were not affected by ARBs.

Both groups of drugs reduce blood pressure in approximately the same way. The appointment of receptor blockers instead of ACE inhibitors makes sense, especially for patients who, while taking the latter, develop a dry cough - a debilitating, common side effect. In other cases, they are the drugs of choice.

In addition to the hypotensive effect, ACE inhibitors, sartans have a number of additional properties that positively affect the dynamics of the course of diseases of the cardiovascular system and related disorders. However, the effect of the work of inhibitors is better studied, although in some diseases the appointment of angiotensin receptor blockers is more justified.

Sartans and the risk of myocardial infarction

In the 2000s, several studies were published that showed an association between ARBs and a slight increase in the risk of heart attack. A more detailed study of this issue did not confirm or refute their conclusions, since the results were contradictory.

However, even the most ardent skeptics are forced to admit that with the most pessimistic forecasts, this risk is very small. Much more dangerous is uncontrolled high blood pressure, unhealthy lifestyle, diet, smoking.

Sartans for arterial hypertension - a list of drugs, classification by generation and mechanism of action

A deep study of the pathological conditions of the cardiovascular system has made it possible to create receptor blockers for the angiotensin II provoking high blood pressure, known to patients as sartans for arterial hypertension. The main purpose of such drugs is to correct blood pressure, each jump of which brings the onset of serious problems with the heart, kidneys and brain vessels closer.

What are sartans for arterial hypertension

Sartans belong to a group of inexpensive drugs that lower blood pressure. In individuals predisposed to hypertension, these drugs become an essential component of a stable life, greatly improving the prospects for longevity. The composition of the drug contains components that have a corrective effect on pressure throughout the day, they prevent the onset of hypertensive attacks and prevent the disease.

Indications for appointment

The main indication for the use of sartans is hypertension. They are especially indicated for people who acutely tolerate therapy with beta-blockers, because they do not affect the metabolic processes in the body. In patients with heart failure, sartans are prescribed as a drug that slows down the mechanisms that lead to myocardial and left ventricular dysfunction. In neuropathy, they protect the kidneys and counteract the loss of protein in the body.

In addition to the main indications for use, there are additional factors confirming the benefits of sartans. These include the following effects:

• the ability to lower cholesterol;
• reducing the risk of Alzheimer's disease;
• strengthening the aortic wall, which serves as additional protection against the effects of hypertension.

Mechanism of action

With oxygen starvation and a decrease in blood pressure, a special substance begins to form in the kidneys - renin, which transforms angiotensinogen into angiotensin I. Further, angiotensin I, under the influence of special enzymes, converts angiotensin II, which, adhering to receptors sensitive to this compound, causes hypertension. The drugs act on these receptors, preventing hypertensive tendencies.

Benefits of drugs

Due to the high efficiency in the treatment of hypertensive crises, sartans have occupied an independent niche and are considered as an alternative to ACE inhibitors (angiotensin-converting enzyme inhibitors), which previously prevailed in the practice of preventing and treating various stages of hypertension. Proven benefits include:

• improvement of symptoms in patients with heart metabolic insufficiency;
• reducing the risk of stroke, atherosclerosis;
• reducing the likelihood of an attack of atrial fibrillation;
• effective and prolonged blocking of the action of angiotensin II;
• lack of accumulation in the body of bradykinin (which provokes a dry cough);
• well tolerated by the elderly;
• no negative effect on sexual functions.

Classification

There are a lot of trade names of sartans. According to the chemical composition and, as a result, the effect on the human body, drugs are divided into four groups:

• Biphenyl derivatives of tetrazole: Losartan, Irbesartan, Candesartan.
• Non-biphenyl derivatives of tetrazole: Telmisartan.
• Non-biphenyl netetrazoles: Eprosartan.
• Non-cyclic compounds: Valsartan.

List of drugs

The use of sartans has found wide demand in medicine, practicing various methods of therapy for high blood pressure. A list of known and used remedies for secondary hypertension includes:

• Losartan: Renicard, Lotor, Presartan, Lorista, Losacor, Losarel, Cozaar, Lozap.
• Valsartan: Tareg, Nortivan, Tantordio, Valsakor, Diovan.
• Eprosartan: Teveten.
• Irbesartan: Firmasta, Ibertan, Aprovel, Irsar.
• Telmisartan: Prytor, Micardis.
• Olmesartan: Olimestra, Cardosal.
• Kandesartan: Ordiss, Kandesar, Hyposart.
• Azilsartan: Edarbi.

Sartans of the latest generation

The first generation includes those drugs that act exclusively on the hormonal system responsible for blood pressure (RAAS) through the blocking of sensitive AT 1 receptors. Second-generation sartans are bifunctional: they suppress undesirable manifestations of RAAS and have a positive effect on pathogenetic algorithms for lipid and carbohydrate metabolic disorders, as well as on inflammation (non-infectious) and obesity. Experts confidently assert that the future of antagonist sartans belongs to the second generation.

Instructions for use

Angiotensin receptor blockers have appeared on the market relatively recently. They should be taken as prescribed by the doctor in a dosage that depends on the individual characteristics of the patient. Drugs are used once a day, act for 24-48 hours. The persistent effect of sartans manifests itself after 4-6 weeks from the moment of treatment. Medications relieve spasms of the vascular wall in symptomatic renal hypertension; they can be prescribed as part of complex therapy for resistant hypertension.

Telmisartan

A popular drug that is part of the angiotensin receptor blockers group is Telmisartan. Indications for the use of this antagonist are the prevention of cardiovascular diseases and the treatment of essential hypertension, it reduces the hypertrophy of cardiocytes, reduces the level of triglycerides. Tablets are taken orally, regardless of food intake, in elderly patients and in liver failure, dose adjustment of the drug is not carried out.

The recommended dosage is 40 mg per day, sometimes it can be reduced to 20 mg (renal failure) or increased to 80 (if systolic pressure does not drop stubbornly). Telmisartan is well combined with thiazide diuretics. The course of treatment lasts approximately 4-8 weeks. At the beginning of therapy, blood pressure should be monitored.

Features of the treatment of hypertension (hypertension) with sartans

Sartans are called special agents, the action of which is directed to angiotensin II receptor blockers. Often doctors prescribe them to patients suffering from hypertension, since with the help of these medicines it is possible to improve the condition of the pathology.

Impact principle

During the process of lowering pressure in the kidneys, an oxygen deficiency is formed, as a result of which renin is produced. It is with its help that angiotensin I appears, which is converted to angiotensin II. This substance is considered to be an active component that has an effect on pressure, increasing it. Therefore, taking sartans in the presence of arterial hypertension in a patient helps to influence receptors, which prevents hypertension.

Advantages

It is believed that the most effective drugs for hypertension are sartans, they have a number of advantages:

• there is no dependence on long-term use;
• with normal blood pressure, drugs do not reduce it;
• well tolerated and have a minimum of negative effects.

Also, drugs improve renal functioning in diabetic nephropathy, guarantee regression of ventricular hypertrophy of the heart and normalize indicators in heart failure.

To achieve maximum effectiveness, scientists recommend using diuretics simultaneously with angiotensin II. For example, "Indapamide" and "Dichlothiazide". Experts note that if you follow this rule, you can increase the effectiveness by 1.5 times. Thanks to thiazide diuretics, not only the effect is enhanced, but the work of the drugs is also prolonged.

Indapamide

Additional effects of these medicines:

1. Provides protection to the cells of the nervous system. The drug minimizes the adverse effects of the disease on the brain, being a prophylactic against stroke. Because they affect the brain, doctors often prescribe them to patients who have normal blood pressure but are at risk for vascular disease.
2. The threat of atrial fibrillation paroxysm is reduced, which is ensured with the help of antiarrhythmic effects.
3. Reduces the risk of diabetes. The metabolic effect is responsible for this, and in the presence of this disease, the patient's condition will return to normal, as insulin resistance of tissues is carried out.

Important! Such substances during hypertension normalize lipid metabolism, reduce cholesterol, as well as triglycerides, the volume of uric acid. All this is very important when taking diuretics.

Some sartans are beneficial for Marfan syndrome, they strengthen blood vessels and prevent their possible rupture. The muscle condition is also normalized. Such an effect has "Losartan".

Losartan

Medical experts prescribe sartans for people who have:

1. Hypertension, which is the main indicator for their use.
2. Heart failure, which can develop against the background of overactive activity of the renin-angiotensin-aldosterone system. At an early stage, it allows to normalize cardiac function.
3. Nephropathy is a dangerous consequence of diabetes, arterial hypertension. With the disease, there is a decrease in the amount of proteins excreted in the urine. Medicines help slow down the development of kidney failure.

Such drugs do not affect metabolism, bronchial patency, organs of vision. In rare cases, they can cause a dry cough, an increase in potassium levels. The effect of the use of medicines will be visible in a month.

Peculiarities

Self-treatment with sartans is prohibited, the treatment regimen should be selected by the doctor individually for each patient. Before prescribing drugs, a special diagnosis is carried out, and the features of the patient's condition are studied.

Important! Drugs must be taken every day, without interruption.

Doctors often prescribe a combination of sartans and diuretics. The most well-known drugs for the treatment of hypertension are:

"Micardis", it contains hydrochlorothiazide, as well as telmisartan;

Micardis
"Teveten" has hydrochlorothiazide and eprosartan as its basis;

Teveten

These substances are also responsible for the protection of internal organs, they are safe, as they do not have side effects.

Classification of drugs

The cost of drugs depends on the manufacturer, duration of action. When using the cheapest medicines, the patient must understand that they need to be drunk more often, since they have a short effect.

Drugs are divided according to composition and effect. Doctors divide them into prodrugs and active substances, based on the presence of an active metabolite. According to the chemical composition, sartans are:

• biphenyl derivatives of tetrazole - "Losartan", "Candesartan" and "Irbesartan";
• non-cyclic - "Valsartan";

Valsartan

Often, patients with arterial hypertension have comorbidities that require the appointment of combined drugs. In this regard, you should be aware of the compatibility of medicines with prescribed sartans:

• The combination of sartans with ACE inhibitors is undesirable due to the same mechanism of action.
• The appointment of diuretics (diuretics), drugs with ethanol, antihypertensive drugs may enhance the hypotensive effect.
• Non-steroidal anti-inflammatory drugs, estrogens, sympathomimetics weaken their effectiveness.
• Potassium-sparing diuretics and potassium-containing drugs can lead to hyperkalemia.
• Lithium preparations lead to an increase in the concentration of lithium in the blood, increase the risk of toxic effects.
• Warfarin reduces the concentration of sartans, increases prothrombin time.

There are various classifications of A-II blockers. Substances are divided into groups according to their chemical composition and effect on the body.

Taking into account the latest generation of compounds, the following classification is proposed:

These are the main medicines. The pharmaceutical industry sells sartans for monotherapy, combined drugs, the list of which is very impressive. They are known by many trade names.

Classification of drugs

There are several types of sartans for arterial hypertension. They differ from each other in what they consist of. There are such types of medicines:

• Biphenyl derivatives of tetrazole.
• Tetrazole derivatives of the non-biphenyl type.
• non-cyclic compounds.
• Non-biphenyl tetrazole.

A new generation of sartans also appeared in pharmacies, which were slightly improved. These include Telmisartan, which is produced under the trademarks "Micardis", "Hipotel".

Controlled pathologies

The scope of application of sartans in the medical business is diverse.

AT1 receptor antagonists give a good effect in such conditions and diseases:

• Arterial hypertension;
• Heart failure;
• Cardiac ischemia;
• myocardial infarction;
• Violation of cerebral circulation;
• Diabetes;
• Nephropathy;
• Atherosclerosis;
• Myodystrophy;
• sexual dysfunction.

How do they act?

The action of sartans is aimed at lowering blood pressure. A hypotensive effect is achieved due to the fact that the active substance of the drugs blocks the angiotensin II receptors. This allows you to normalize the state of the blood vessels, expand them, and relieve the excess load from the heart. All this helps to stabilize blood pressure.

In addition to blood pressure, sartans protect the body from complications that may arise due to hypertension. Medicines help to protect the work of the kidneys, blood vessels, heart, visual organs, brain.

Indications for appointment

All antihypertensive drugs known to modern medicine have every right to prescribe. They are used in monotherapy, in combination with other medicines.

Antagonists A-II are used when, under certain conditions, they are more preferable.

Among antihypertensive forms, angiotensin II receptor blockers occupy the first position in this case:

• Increase in systolic pressure indicator;
• Arterial hypertension associated with disorders of cerebral circulation;
• Intolerance to angiotensin-converting enzyme inhibitors (ACE inhibitors);
• Hypertension plus diabetes mellitus complicated by diabetic nephropathy.

The main indication for the use of sartans is hypertension. They are especially indicated for people who acutely tolerate therapy with beta-blockers, because they do not affect the metabolic processes in the body. In patients with heart failure, sartans are prescribed as a drug that slows down the mechanisms that lead to myocardial and left ventricular dysfunction. In neuropathy, they protect the kidneys and counteract the loss of protein in the body.

In addition to the main indications for use, there are additional factors confirming the benefits of sartans. These include the following effects:

• the ability to lower cholesterol;
• reducing the risk of Alzheimer's disease;
• strengthening the aortic wall, which serves as additional protection against the effects of hypertension.

All antihypertensive drugs known to modern medicine have every right to prescribe. They are used in monotherapy, in combination with other medicines. Their purpose determines the mechanism of action, the sensitivity of the patient to the drug. Antagonists A-II are used when, under certain conditions, they are more preferable.

Which to choose?

Which drug from the group of sartans to choose is up to the specialist to decide. The medication is selected depending on the existing degree of hypertension, the presence of concomitant diseases, the individual characteristics of the organism and other factors.

All of them have the same therapeutic effect, but have a different composition.

It is very difficult to selectively name the sartans that are used for hypertension. All ARBs are suitable for initiation and long-term treatment of hypertension. However, clinical studies and practical use have revealed some superiority in prescribing drugs under certain conditions in comparison with drugs from other groups.

Please note! It is impossible to prescribe two sartans to patients at the same time.

The question often arises, which drug to choose among angiotensin 2 receptor blockers. Also, many are wondering if Losartan or Valsartan is better, since these ARB drugs are similar in their characteristics.

Instructions for use

Sartans are allowed to be taken only as prescribed by the attending doctor. The specialist himself determines the optimal dosage, frequency and duration of administration, based on the instructions for use of a particular agent.

Drink a tablet once a day. This is quite enough, because the effect of the drug lasts for a long time. The pills should be taken orally with plenty of water.

After about 4 weeks of treatment with sartans, patients manage to achieve a stable decrease in blood pressure.

Angiotensin receptor blockers have appeared on the market relatively recently. They should be taken as prescribed by the doctor in a dosage that depends on the individual characteristics of the patient. Drugs are used once a day, act for 24-48 hours. The persistent effect of sartans manifests itself after 4-6 weeks from the moment of treatment.

The dosage is prescribed by the doctor, based on the individual characteristics of the patient. Medicines are drunk once a day, the effect occurs during the day. The effect appears after about four weeks from the start of use. Sartans can be prescribed as part of a comprehensive treatment.

Telmisartan is a very common drug. It is prescribed for prophylactic purposes to prevent cardiovascular disease and essential hypertension. When used, the level of triglycerides and hypertrophy of cardiocytes decreases.

Medicines are taken orally, whether before or after meals. The dosage does not change when used in old age and with liver failure.

Usually prescribed 40 mg per day. In rare cases, it is reduced by half (with renal failure) or increased to 80 mg (if there is no sufficient effect). The drug is sometimes taken together with thiazide diuretics. The therapy lasts 1-2 months. During treatment, it is important to control blood pressure.

Losartan is an equally popular drug. It comes in the form of tablets. Its dosage is usually 100 mg. It is enough to provide a hypotensive effect. The tablets are film-coated and are taken once a day. If it is not possible to achieve the desired effect, the dose is doubled.

ARBs are relatively new drugs on the market. The drug and dosage are prescribed by the doctor, taking into account the individual characteristics of the body.

There are two most popular drugs - angiotensin 2 receptor blocker:

• Telmisartan. An antagonist that is taken in the prevention of cardiovascular disease and the treatment of hypertension. Tablets are taken orally, regardless of the meal. The recommended dosage of the drug is 40 mg per day. In case of renal insufficiency, it is reduced to 20 mg, and if it is not possible to reduce the upper pressure, then it is increased to 80 mg. The course of treatment lasts approximately 4-8 weeks. At the beginning of therapy, it is recommended to control blood pressure. Doctors recommend taking telmisartan to prolong life.

• Losartan. The drug is an angiotensin II receptor blocker in tablets, taken starting from a dose of 100 mg. Such an amount may provide hypotensive effects. Tablets are taken once a day. If this dose does not have the desired effect, then it is increased up to two tablets per day.

Compatibility with other drugs

With the development of hypertension, doctors usually prescribe combinations of drugs to patients. At the same time, you should know with which medicines you can take sartans, and with which you can’t. Sartans are combined with such medicines as:

• Diuretics. Together with them, a stronger therapeutic effect is achieved with high blood pressure.
• Beta-blockers, antiarrhythmics. Their combination with sartans is possible if the patient suffers from cardiac arrhythmias.
• Nitrates. Simultaneous reception with them is required if a person has angina pectoris.
• Antiplatelet agents. They are used for violations in the work of the heart, they go well with sartans.

You should not take sartans with ACE inhibitors because there is no point in doing so. Both groups of drugs have almost the same effect.

There are a number of drugs with which it is not recommended to combine sartans. These include the following:

1. Non-steroidal anti-inflammatory drugs.
2. Estrogens.
3. lithium preparations.
4. Medicines containing ethyl alcohol.
5. potassium-sparing medications.

When prescribing the drug, the doctor must take into account the features of drug interactions.

Not all drugs are compatible with each other, therefore, self-administration of sartan is prohibited.

Often patients with hypertension have comorbidities that require combination therapy.

Therefore, it will not be superfluous to know about the compatibility of medicines with prescribed sartans:

1. Do not use ARBs with ACE inhibitors because they have same mechanism of action I.
2. Diuretics (diuretics), drugs with ethanol, AR drugs may increase the hypotensive effect.
3. Medications containing lithium lead to an increase in the concentration of this substance in the blood, and increase the risk of toxic effects.
4. Warfarin leads to a decrease in concentration BRA.

Benefits of using

When choosing a medicine for the treatment of arterial hypertension, the questions of taking a medication are not the last place in patients.

In this regard, sartans have their own number of preferences:

1. Prescription blockers A-II can be taken for a long time, 2-3 years.
2. Side effects from their use are mostly negligible.
3. These medicines for the treatment of hypertension are drunk once or twice a day.
4. Medications lower blood pressure slowly over the course of a day.
5. ARBs do not lower blood pressure in people with normal blood pressure.
6. The body does not get used to the drug.
7. Sudden withdrawal of the sartan does not provoke a pressure surge.
8. New antihypertensive drugs are good therapeutic agents and effective prophylactic agents.

Sartans and treatment of arterial hypertension

Pharmacology in the modern world does not stand still and is actively developing. And many drugs are used to treat hypertension. One of these are sartans - drugs, the list of which is very long.

Sartans is another name for a group of angiotensin II receptor blocking drugs. This is a relatively new group of drugs that was discovered through a thorough study of the processes of the course and treatment of diseases of the cardiovascular system.

When blood pressure drops, the human body produces a substance called renin. As a result of a chain of certain processes, it is converted into angiotensin II. As a result of the binding of this compound to the receptors, a sharp jump in pressure occurs.

The work of sartans for the treatment of hypertension is based on blocking the interaction of receptors and angiotensin II. In addition, thanks to these drugs, the connection of this substance with chymas enzymes, the activity of which increases the risk of developing hypertension, is stopped. It turns out that sartans have a wide spectrum of action.

Sartans for arterial hypertension are affordable medicines. In people prone to hypertension, they become an integral part of a stable life, improving well-being and prolonging life. The active substances are able to correct indicators throughout the day, help prevent attacks of hypertension and work great as a means of preventing severe degrees of the disease.

Despite the relatively recent use in medicine, sartans have managed to earn the trust of physicians and patients. The undeniable advantages of drugs include:

• good tolerance by the body;
• the minimum number of side effects with strict adherence to the doctor's instructions;
• efficiency;
• low risk of pressure drop;
• cumulative effect - the maximum result is observed from the fourth day from the start of therapy.

A deep study of the pathological conditions of the cardiovascular system has made it possible to create receptor blockers for the angiotensin II provoking high blood pressure, known to patients as sartans for arterial hypertension. The main purpose of such drugs is to correct blood pressure, each jump of which brings the onset of serious problems with the heart, kidneys and brain vessels closer.

Sartans belong to a group of inexpensive drugs that lower blood pressure.

In individuals predisposed to hypertension, these drugs become an essential component of a stable life, greatly improving the prospects for longevity.

The main indication for the use of sartans is hypertension. They are especially indicated for people who acutely tolerate therapy with beta-blockers, because they do not affect the metabolic processes in the body.

In patients with heart failure, sartans are prescribed as a drug that slows down the mechanisms that lead to myocardial and left ventricular dysfunction.

In neuropathy, they protect the kidneys and counteract the loss of protein in the body.

Mechanism of action

With oxygen starvation and a decrease in blood pressure, a special substance begins to form in the kidneys - renin, which transforms angiotensinogen into angiotensin I.

The drugs act on these receptors, preventing hypertensive tendencies.

Due to the high efficiency in the treatment of hypertensive crises, sartans have occupied an independent niche and are considered as an alternative to ACE inhibitors (angiotensin-converting enzyme inhibitors), which previously prevailed in the practice of preventing and treating various stages of hypertension. Proven benefits include:

• improvement of symptoms in patients with heart metabolic insufficiency;
• reducing the risk of stroke, atherosclerosis;
• reducing the likelihood of an attack of atrial fibrillation;
• effective and prolonged blocking of the action of angiotensin II;
• lack of accumulation in the body of bradykinin (which provokes a dry cough);
• well tolerated by the elderly;
• no negative effect on sexual functions.

Classification

There are a lot of trade names of sartans. According to the chemical composition and, as a result, the effect on the human body, drugs are divided into four groups:

• Biphenyl derivatives of tetrazole: Losartan, Irbesartan, Candesartan.
• Non-biphenyl derivatives of tetrazole: Telmisartan.
• Non-biphenyl netetrazoles: Eprosartan.
• Non-cyclic compounds: Valsartan.

List of drugs

The use of sartans has found wide demand in medicine, practicing various methods of therapy for high blood pressure. A list of known and used remedies for secondary hypertension includes:

• Losartan: Renicard, Lotor, Presartan, Lorista, Losacor, Losarel, Cozaar, Lozap.
• Valsartan: Tareg, Nortivan, Tantordio, Valsakor, Diovan.
• Eprosartan: Teveten.
• Irbesartan: Firmasta, Ibertan, Aprovel, Irsar.
• Telmisartan: Prytor, Micardis.
• Olmesartan: Olimestra, Cardosal.
• Kandesartan: Ordiss, Kandesar, Hyposart.
• Azilsartan: Edarbi.

The first generation includes those drugs that act exclusively on the hormonal system responsible for blood pressure (RAAS) through the blocking of sensitive AT 1 receptors.

Second-generation sartans are bifunctional: they suppress undesirable manifestations of RAAS and have a positive effect on pathogenetic algorithms for lipid and carbohydrate metabolic disorders, as well as on inflammation (non-infectious) and obesity.

Experts confidently assert that the future of antagonist sartans belongs to the second generation.

Sartans are a new generation of drugs. They are used to lower blood pressure in the diagnosis of "arterial hypertension". Medicines began to be synthesized in the nineties of the twentieth century. Sartans have an extensive list of drugs, a minimum of side effects and contraindications.

Sartans are prescribed in the following cases:

• arterial hypertension. The remedy is effective if there is also left ventricular hypertrophy. The drugs lower the pressure, but the result begins to manifest itself in full after 3-4 weeks from the start of the intake.
• Chronic heart failure. ACE inhibitors and sartans prevent heart disease in the early stages. The drugs reduce the rate of development of chronic heart failure and prevent the occurrence of heart attacks and strokes.
• Nephropathy. Kidney problems can occur against the background of consistently high blood pressure. They are also sometimes the cause of hypertension.
• Cardiovascular disease in type 2 diabetes mellitus. If you take sartans constantly, the utilization of glucose by body tissues improves, as insulin resistance decreases. This brings blood glucose levels back to normal.
• Cardiovascular diseases in dyslipidemia. The drugs normalize blood cholesterol levels.

The cause of high blood pressure is an increased tone of the arteries. Sartans are angiotensin II receptor blockers (ARBs) that normalize blood vessels. After that, the load on the heart decreases, as the process of pushing blood into the vessels is facilitated, and blood pressure decreases to an acceptable level.

Also, drugs protect the retina, the inner wall of blood vessels, the heart, kidneys and brain from the effects of hypertension.

If, in addition to high blood pressure, increased blood viscosity, diabetes, malnutrition, a sedentary lifestyle and bad habits are observed, a person is at risk of suffering from a stroke and heart attack in his youth.

Sartans are necessary not only for the treatment of hypertension, but also for its severe consequences.

Sartans for arterial hypertension have gained recognition among patients and doctors. They have many advantages over conventional medicines:

• Long-term use of drugs (more than 2 years) does not lead to addiction and dependence. Abrupt termination also does not lead to an instantaneous increase in pressure.
• The use of the drug with normal blood pressure does not lead to hypotension.
• Tolerability among patients (even in old age) is at a high level, there are practically no side effects.
• Sartans not only reduce blood pressure, but also have a positive effect on the kidneys if a person suffers from diabetic nephropathy. There is a regression of left ventricular hypertrophy. Medicines also help in the treatment of heart failure. The positive effect is enhanced by 1.5 times if diuretic drugs such as Indapamide and Dichlothiazide are taken together with sartans. Thiazide diuretics prolong the effect of the drug.
• There is protection of nerve cells and the brain, which prevents the occurrence of a stroke. Sartans can be prescribed at normal pressure if there is a danger of a vascular catastrophe in the brain.
• Sartans reduce the likelihood of paroxysmal atrial fibrillation.
• Taking medications reduces the risk of developing type 2 diabetes. If the disease is present, the drug reduces tissue insulin resistance, which facilitates treatment.
• There is an improvement in lipid metabolism, cholesterol and triglycerides are lowered.
• The level of uric acid in the blood decreases, which is important with long-term use of diuretics.
• If there are pathologies of the connective tissues, then the walls of the aorta are strengthened, which reduces the risk of rupture.
• The drug is prescribed to patients with Duchenne myodystrophy to improve the condition of muscle tissue;
• The body does not accumulate bradykinin, which causes a dry cough.

Studies have been conducted that angiotensin receptor blockers prevent the development of many malignant tumors. They are sometimes used in chemotherapy to enhance drug delivery by unpacking tumor vessels.

Classification

Drugs are divided according to the effect on the patient and the chemical composition. There are active substances and prodrugs depending on the presence of the active metabolite.

How they are applied

Instructions for use are available for each individual drug. The instructions reflect the peculiarity of the appointment of the drug, its dosage, given information about contraindications. The rules for using the new sartan derivative Olmesartan were not found in Internet sources.

• When prescribing the drug, the results of a thorough examination and the individual characteristics of the patient are taken into account;
• The drug is dosed according to the instructions for use, the mechanism of action on a particular patient;
• Medicines are taken daily, without gaps, for a long time.

Sartans are widely used in combination with other drugs. In the treatment of heart failure, good prognoses are obtained from the combination of AT1 receptor blockers with beta-blockers.

RAS blockers are perfectly combined with diuretics, in particular with hydrochlorothiazide. For example, this diuretic was combined with Candesartan in Atacand. With Eprosartan, hydrochlorothiazide is combined in the drug Teveton, with Telmisartan - in the drug Micardis. Medicines combined for the treatment of hypertension prevent the occurrence of stroke, kidney dysfunction, myocardial infarction, etc.

Effects on the heart, kidneys

Before prescribing, the doctor will definitely evaluate the possibility of the effect of drugs on the functioning of the heart and kidneys.

Impact on the heart

With a decrease in blood pressure levels through the use of sartans, patients do not experience an increase in heart rate. Particularly good results are obtained by blockade of the action of the renin-angiotensin-aldosterone system in the heart muscle and vascular walls. This helps to prevent hypertrophy of the heart and blood vessels. Sartans help reduce the manifestations of atherosclerosis of the heart vessels.

Sometimes side effects after taking the pills are headaches and dizziness.

Effect on the kidneys

In people with diabetes mellitus and kidney damage, when sartans are prescribed, the condition improves significantly.

The drug-controlled pathology is proteinuria. With the development of this disorder, the concentration of protein in the urine increases, and in patients with concomitant diabetes mellitus, the risk of developing acute kidney failure increases.

Sartans help to reduce the concentration of protein in the urine, preventing a sharp violation of the functioning of the kidneys. It also helps to lower blood pressure levels.

The kidneys are most dangerous in hypertensive disease, an increase in glomerular filtration. This provokes organ dysfunction. Sartans gradually reduce filtration, preventing pathologies from actively developing.

With bilateral narrowing of the renal artery, sartans will need to be canceled so as not to cause renal failure.

Unwanted Effects

AT1 receptor blockers do not cause any particular complaints from patients. But there are adverse reactions to this class of drugs. When they are taken, headaches, dizziness, fatigue are observed. Sometimes the temperature rises.

Comparative characteristics of some side effects will help determine the choice of medication.

Innovative generations of sartans still have to undergo multiple clinical trials. At the same time, the statement remains true: in the prevention, treatment of hypertension, and the effect on target organs, they are not inferior, and in some cases they are superior to ACE and other antihypertensive drugs.

Additional effects

If we compare the effects on the body of the main groups of drugs to lower blood pressure and sartans, then the latter have clear advantages. These include:

• Good tolerance by the body, because there is no effect on the metabolism of bradykinin. In this regard, a dry painful cough and angioedema never occur as side effects.
• Prolonged action, stable decrease and retention at a normal level of blood pressure.
• Slowing down not only the main actions of angiotensin II, but also additional ones.
• No negative impact on the concentration of uric acid, cholesterol and blood sugar.
• Reducing the risk of death associated with myocardial infarction.
• Obtaining additional protection by brain cells, normalization of the ability to mental work and memory in people in old age.
• Improving potency.
• Strengthening of the walls of the aorta in case of aneurysm in people with Marfan syndrome.
• Improving the metabolism of fats and carbohydrates.
• Normalization of metabolism in people with obesity.

Sartans are often substituted for ACE inhibitors when the latter are not effective or are not tolerated.

ARBs improve lipid metabolism by lowering total cholesterol, low-density lipoprotein cholesterol, and triglycerides.

These drugs reduce the content of uric acid in the blood, which is important with simultaneous long-term therapy with diuretics.

The effect of some sartans in diseases of the connective tissue, in particular, in Marfan's syndrome, has been proven. Their use helps to strengthen the aortic wall in such patients, prevents its rupture. Losartan improves the condition of muscle tissue in Duchenne myodystrophy.

Side effects when taking

• hypotension;
• nausea and weakness;
• dizziness;
• sleep problems;
• headache;
• stomach ache;
• pathological change in body temperature;
• muscle and joint pain.

The causes of side effects of drugs are usually the wrong intake or violation of the dosage. These symptoms should be the reason for contacting a doctor to review the dose or change the medication. If necessary, the doctor will select an analogue that is appropriate in the current situation.

List of drugs

Sartans, or angiotensin II receptor blockers (ARBs), emerged as a result of in-depth study of the pathogenesis of diseases of the cardiovascular system. This is a promising group of medicines, already occupying a strong position in cardiology. We will talk about what these drugs are in this article.

The first generation includes those drugs that act exclusively on the hormonal system responsible for blood pressure (RAAS) through the blocking of sensitive AT 1 receptors. Second-generation sartans are bifunctional: they suppress undesirable manifestations of RAAS and have a positive effect on pathogenetic algorithms for lipid and carbohydrate metabolic disorders, as well as on inflammation (non-infectious) and obesity. Experts confidently assert that the future of antagonist sartans belongs to the second generation.

With an increase in blood pressure, it is recommended to use sartans that belong to different groups to stabilize the indicators.

Treatment is carried out with such drugs:

1. Losartan is a drug that has a persistent hypotensive effect. The drug should be taken at a dosage of 100 milligrams per day. Patients are recommended to take the tablets once orally. If the desired effect is insufficient, then the dosage of the drug is doubled.
2. Telmisartan is recommended for patients with essential hypertension. The action of the drug is aimed at reducing the hypertrophy of cardiocytes and reducing the level of triglycerides. It is recommended to take the medicine inside, regardless of food. If treatment is carried out in old age, with hepatic or renal insufficiency, then dosage adjustment is not required. The drug should be taken at 40 milligrams twice a day. In case of renal insufficiency, the dosage should be halved. If a decrease in performance is not observed for a long time, then the dose of the drug is increased to 80 milligrams. Treatment is carried out in a course, the duration of which is from 4 to 8 weeks.
3. Ibersartan has an antihypertensive effect. After taking the medicine inside, its maximum concentration in the blood is reached after two hours. To achieve a therapeutic effect, it is recommended to take the medicine in a course, the duration of which is 1-2 weeks. The European medicine is recommended to take 150 milligrams once a day. Gradually it is recommended to increase the dosage to 300 milligrams. The medication should be taken daily at the same time. It is strictly forbidden to use the drug during pregnancy and lactation.
4. Eprosartan is an antihypertensive medication available over the counter with a prescription from a doctor. The action of the drug is aimed at treating diseases of the cardiovascular system, which are accompanied by a persistent increase in blood pressure. After the first dose of the drug, its effect lasts a day. The patient should take the medicine in the morning at 600-800 milligrams. The course of treatment with the drug is determined by the doctor. Persistent stabilization of blood pressure indicators is observed after 2-3 weeks after the first dose of the drug. The maximum daily dosage of the drug is 1200 milligrams. Improper use of the drug leads to vomiting, diarrhea, asthenia, skin rash and itching, headaches.
5. Valsartan is a drug for the treatment of hypertension, congestive heart failure, myocardial infarction. The medication is recommended for children over 6 years of age. In severe liver disorders, pregnancy, hypersensitivity, breastfeeding, the drug is not used. Reception
   tablets are administered orally. They are washed down with plenty of water. Children are given 40 milligrams of medication once a day, regardless of food intake. Adult patients should take the same amount twice a day. The maximum dosage of the drug for adult patients is 320 milligrams.
6. Candensartan is an innovative medicine that is used for systematically increasing blood pressure. If the patient is diagnosed with heart failure or the work of the left ventricle is disturbed, then the drug is used in combination with other medicines. You need to use the medicine 1 time per day. The patient is recommended to use from 4 to 8 mg of the drug. The dosage is determined by the doctor according to the individual characteristics of the patient. Irrational medication leads to dizziness, pain in the stomach, swelling, rashes on the skin.
7. Azilsartan has a pronounced antihypertensive effect. The use of the drug is recommended for patients who have an essential type of hypertension. At the initial stage of the disease, it is recommended to take 40 milligrams of the drug. If necessary, the dosage is doubled after prior consultation with the doctor. The drug is allowed from the age of 5. In diabetes mellitus, hypersensitivity and pregnancy, the medicine is not recommended.

What it is?

Pay attention to the main effects of angiotensin II

Sartans, or as they are also called angiotensin 2 receptor blockers, are drugs that help reduce pressure in arterial hypertension.

It should be noted that angiotensin II is formed due to the angiotensin-converting enzyme.

Its action is as follows:

1. Narrowing of blood vessels.
2. The resistance of peripheral blood vessels increases.
3. Increase in blood pressure.

Accordingly, the use of angiotensin 2 receptor blockers control pressure and its normalization.

ARB preparations contain components that contribute to the correction of pressure throughout the day, prevent attacks of hypertension and have a beneficial effect on its treatment.

ARBs are as good as many popular drugs, although the price is much lower than many drugs for lowering blood pressure. Also, the action of sartans has practically no side effects and has a beneficial effect on the functioning of the cardiovascular system, brain and kidneys.

Combined with diuretics

With simultaneous treatment with sartans and thiazide diuretics, the effectiveness of the latter increases. At the same time, the former help to reduce the loss of potassium by the body, which is usually provoked by the latter.

The most common and effective combination in one preparation of sartan and a diuretic is preparations with 12.5 mg of hydrochlorothiazide. These medicines include:

• Vazar N;
• Lorista;
• Micardis plus;
• Gizaar Forte.

Sartans are a good complement to calcium channel blockers. There are even drugs with three components containing valsartan, amlodipine and hydrochlorothiazide.

The latest generation drugs

With the development of medical science, the structures of drugs are being improved. Sartans were eventually proposed to be divided into 2 generations:

• 1st generation - can only block angiotensin II receptors (Losartan and others);
• 2nd generation - in addition to blocking angiotensin II, they also block the receptor link of its activation, that is, they are characterized by a dual mechanism. So far, only telmisartan belongs to this group (contained in the preparations Mikradis, Hypotel).

An interesting feature was the chemical structure of the latest generation of sartan. It was derived from the first sartan, losartan. As a result, the telmisartan molecule is similar to the drugs used to treat type 2 diabetes.

In terms of activity, telmisartan is noticeably superior to losartan, it has a stronger effect on the risk factors for atherosclerosis, hypertension and diabetes mellitus:

• reduces blood sugar;
• increases tissue reactivity to insulin;
• reduces the concentration of cholesterol and triglycerides.

Telmisartan does not need to be converted into an active compound - this makes it possible to prescribe it for liver pathologies. The substance penetrates tissues more actively, the duration of its exposure is the longest among all sartans, and a single dose per day is enough to control pressure. Telmisartan helps to prevent a jump in high blood pressure in the morning, and therefore the risks of developing strokes and heart attacks in patients treated with Hypotel or Micardis are reduced.

Telmisartan is less than others excreted through the kidneys - no more than 1%. Because of this, impaired renal function does not affect the pharmacokinetics of the drug, which makes it possible to use telmisartan in hemodialysis.

Sartans: action, use, list of drugs, indications and contraindications

Scientists have reliably identified all the risk factors leading to the development of pathology of the heart and blood vessels several decades ago. Moreover, this pathology plays an important role in young people. The sequence of development of processes in a patient with risk factors from the moment of their occurrence to the development of terminal heart failure is called the cardiovascular continuum.

In the latter, in turn, the so-called "hypertensive cascade" is of great importance - a chain of processes in the body of a patient suffering from hypertension, which is a risk factor for the occurrence of more serious diseases (stroke, heart attack, heart failure, etc.). Among the processes that can be influenced are those that are regulated by angiotensin II, the blockers of which are the sartans considered below.

So, if it was not possible to prevent the development of heart diseases by preventive measures, the development of more severe heart diseases should be “delayed” in the early stages. That is why patients with hypertension should carefully monitor blood pressure numbers (including by taking medications) in order to prevent left ventricular systolic dysfunction and the resulting adverse consequences.

Can they cause cancer

A large number of medical scientific studies have been conducted to establish the relationship between the impact of regular treatment with sartans and the development of oncology. The results suggest that people treated with sartans on an ongoing basis have an increased risk of developing cancer compared to those treated with other drugs.

Despite the conclusion made by scientists, doctors are still not exactly sure whether sartans can really provoke cancer. In medicine, there is no complete data on how a particular drug is involved in the onset of cancer, so it cannot be argued that sartans definitely cause the disease.

Today, research on this issue continues, and the opinions of researchers on this issue can be completely opposite.

So, the process of therapy with sartans needs to be organized taking into account the instructions of the doctor. It is forbidden to take drugs during pregnancy and breastfeeding. Sartans are also contraindicated for children. For elderly people, the dose is selected individually, taking into account the characteristics of their body, usually these drugs are used in combination with other drugs.

Sartans are effective means to help control high blood pressure and prevent attacks of hypertension. Adverse reactions, subject to the rules of application, almost do not occur. To achieve a positive effect, you need to be attentive to the doctor's prescriptions, pay attention to contraindications and nuances of use, and report on the dynamics of treatment.

The mechanism of action of sartans - angiotensin II receptor blockers

It is possible to break the pathological chain of processes occurring in the human body with arterial hypertension by influencing one or another link of pathogenesis. So, it has long been known that the cause of hypertension is an increased tone of the arteries, because, according to all the laws of hemodynamics, fluid enters a narrower vessel under greater pressure than a wide one.

The renin-aldosterone-angiotensin system (RAAS) plays a leading role in the regulation of vascular tone. Without delving into the mechanisms of biochemistry, it is enough to mention that the angiotensin-converting enzyme promotes the formation of angiotensin II, and the latter, acting on receptors in the vascular wall, increases its tension, which results in arterial hypertension.

Based on the foregoing, there are two important groups of drugs that affect the RAAS - angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARBs, or sartans).

The first group - ACE inhibitors include drugs such as enalapril, lisinopril, captopril and many others.

To the second - sartans, the drugs discussed in detail below are losartan, valsartan, telmisartan and others.

So, sartans block receptors for angiotensin II, thereby normalizing increased vascular tone. As a result, the load on the heart muscle is reduced, because now it is much easier for the heart to "push" blood into the vessels, and blood pressure returns to normal.

the effect of various antihypertensive drugs on the RAAS

In addition, sartans, as well as ACE inhibitors, contribute to the provision of an organoprotective effect, that is, they “protect” the retina of the eyes, the inner wall of blood vessels (the intima, the integrity of which is extremely important at high cholesterol levels and in atherosclerosis), the heart muscle itself, the brain and kidneys from the adverse effects of high blood pressure.

Add to high blood pressure and atherosclerosis increased blood viscosity, diabetes mellitus and an unhealthy lifestyle - in a large percentage of cases, you can get an acute heart attack or stroke at a fairly young age. Therefore, not only to correct the level of blood pressure, but also to prevent such complications, sartans should be used if the doctor has determined the patient's indications for taking them.

1. Chronic heart failure.
2. Hypertension.
3. Postponed myocardial infarction.
4. Diabetes mellitus of the second type.
5. Pathologies of the kidneys that caused the development of hypertension.
6. Hypertrophy of the left ventricle of the heart.
7. Cardiovascular pathology with impaired lipid metabolism.

Also, sartans are drugs that are prescribed for intolerance to ACE inhibitors.

When should you take sartans?

Based on the foregoing, the following diseases act as indications for taking angiotensin receptor blockers:

• Arterial hypertension, especially in combination with left ventricular hypertrophy. The excellent hypotensive effect of sartans is due to their effect on the pathogenetic processes occurring in the body of a patient with hypertension. However, patients should take into account that the optimal effect develops after a couple of weeks from the start of daily intake, but nevertheless, it persists throughout the entire period of treatment.
• Chronic heart failure. According to the cardiovascular continuum mentioned at the beginning, all pathological processes in the heart and blood vessels, as well as in the neurohumoral systems that regulate them, sooner or later lead to the fact that the heart cannot cope with the increased load, and the heart muscle simply wears out. In order to stop pathological mechanisms in the early stages, there are ACE inhibitors and sartans. In addition, multicenter clinical studies have shown that ACE inhibitors, sartans and beta-blockers significantly reduce the rate of progression of CHF, as well as reduce the risk of heart attack and stroke to a minimum.
• Nephropathy. The use of sartans is justified in patients with kidney pathology, which caused or resulted from hypertension.
• Cardiovascular pathology in patients with type 2 diabetes mellitus. The constant intake of sartans contributes to better utilization of glucose by body tissues due to a decrease in insulin resistance. This metabolic effect contributes to the normalization of blood glucose levels.
• Cardiovascular pathology in patients with dyslipidemia. This indication is determined by the fact that sartans normalize blood cholesterol levels in patients with high cholesterol levels, as well as with an imbalance between very low, low and high density lipoprotein cholesterol (VLDL cholesterol, LDL cholesterol, HDL cholesterol). Recall that "bad" cholesterol is found in very low and low density lipoproteins, and "good" - in high density lipoproteins.

Are side effects possible?

As with any drug, a drug from this group may also have side effects. However, the frequency of their occurrence is negligible and occurs with a frequency of slightly more or less than 1%. These include:

1. Weakness, dizziness, orthostatic hypotension (with a sharp adoption of a vertical body position), increased fatigue and other signs of asthenia,
2. Pain in the chest, in the muscles and joints of the extremities,
3. Abdominal pain, nausea, heartburn, constipation, dyspepsia.
4. Allergic reactions, swelling of the mucous membrane of the nasal passages, dry cough, redness of the skin, pruritus.

Are there better drugs among sartans?

According to the classification of angiotensin receptor antagonists, four groups of these drugs are distinguished.

This is based on the chemical structure of the molecule based on:

• biphenyl derivative of tetrazole (losartan, irbesartan, candesartan),
• A non-biphenyl derivative of tetrazole (telmisartan),
• Non-biphenyl netetrazole (eprosartan),
• Non-cyclic compound (valsartan).

Despite the fact that sartans themselves are an innovative solution in cardiology, among them, drugs of the latest (second) generation can also be distinguished, significantly superior to previous sartans in a number of pharmacological and pharmacodynamic properties and end effects. To date, this drug is telmisartan (trade name in Russia - "Micardis"). This medicine can rightfully be called the best among the best.

Drugs that block angiotensin II receptors, lowering blood pressure, are called sartans. They are distinguished by good tolerability and effectiveness in the treatment of hypertension. These drugs are prescribed for concomitant metabolic syndrome, kidney damage, myocardial hypertrophy and circulatory failure.

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Mechanism of action

Low oxygen supply to the kidneys (hypotension, hypoxia) leads to the formation of an enzyme - renin. With its help, angiotensinogen passes into angiotensin 1. It also does not cause vasoconstriction, but only after conversion into angiotensin 2 provokes hypertension.

Sufficiently well-known drugs for the treatment of high blood pressure inhibit precisely the latter reaction. They are often prescribed to patients in the form of Capoten. These are the so-called.

But some patients have no reaction to this group of medicines. This stability is explained by the fact that in addition to the angiotensin-converting enzyme itself, there are a number of other compounds involved in such reactions.

Therefore, the appearance of receptor blockers for such an active vasoconstrictor as angiotensin 2 helps to solve several problems at once in the treatment of hypertension.

Effects on the heart, kidneys

A feature of medicines from the sartans group is the ability to protect internal organs. They have a cardio- and nephroprotective effect, increase tissue sensitivity to insulin, which has a positive effect on patients with diabetes, and also reduce progression.

When taking these drugs, the risk of occurrence decreases, especially decreases. Patients are less likely to experience complications, sartans soften the manifestations of circulatory failure.

Nephropathy often complicates hypertension and diabetes mellitus. In this case, the body loses protein in the urine. One of the clinical effects of sartans is to slow down proteinuria with a simultaneous increase in glomerular filtration rate.

Classification of sartans

The distribution of drugs within the group is carried out according to the active substance. Medicines can be based on:

• losartan (Lorista,);
• (Teveten);
• valsartan (Valsacor, Diocor Solo);
• irbesartan (Aprovel);
• candesartana (Casark);
• telmisartan (Micardis, Prytor);
• olmesartan (Olmesar).

Such a good representation of sartans in the pharmacy network is due to the fact that they are gaining more and more popularity among doctors and patients with hypertension.

Indications for use

The main disease in which sartans are used is hypertension. But besides this, there are accompanying indications for the appointment:

• kidney disease in patients with hypertension and diabetes;
• chronic circulatory failure, especially in the presence of contraindications to ACE inhibitors (for example, cough);
• blood flow disorders in the cerebral vessels (transient attacks) in hypertension and myocardial hypertrophy;
• acute period of infarction with dysfunction of the left ventricle.

Watch the video about the appointment of sartans for hypertension and their action:

Additional effects

If we conduct a comparative analysis between the main antihypertensive drugs and sartans, we can find the undoubted advantages of the latter. These include:

• good tolerance, as they do not affect the exchange of bradykinin. This means that dry cough and angioedema do not develop;
• prolonged and stable lowering of blood pressure;
• inhibit the main and additional effects of angiotensin 2;
• do not increase the content of uric acid, sugar and cholesterol;
• reduce mortality from;
• protect brain cells, improve memory and mental activity in the elderly;
• improve potency;
• strengthen the wall of the aorta in patients with;
• improve carbohydrate and fat metabolism, can be used in obese patients;
• prescribed with a weak effectiveness of ACE inhibitors or their intolerance.

Contraindications

Despite the relative safety, the appointment of sartans can only be carried out by a doctor, they are not recommended for:

• hypersensitivity to any of the components of the drug;
• impaired liver function, cirrhosis and bile stasis;
• insufficiency of kidney function requiring hemodialysis;
• pregnancy and lactation.

Side effects when taking

The drugs are distinguished by rare side effects in the form of dizziness and nausea, abdominal pain. In patients with myocardial infarction, a headache was also noted, hypotension occurs when standing up (), asthenia.

With dehydration or forced excretion of fluid in patients taking sartans, blood pressure may drop significantly. Therefore, in such cases, before starting treatment, it is necessary to restore the volume of circulating blood and the concentration of sodium.

Combined with diuretics

When used together with diuretics, their strength increases, and sartans reduce the loss of potassium caused by. The most common is the combination with 12.5 mg of hydrochlorothiazide.

Preparations of this composition are:

It is considered one of the most modern Valsartan for pressure. The antihypertensive agent may be in the form of tablets and capsules. The medicine helps even those patients who develop a cough after conventional drugs for pressure.

Sartans are the latest generation of pressure drugs that appeared 20 years after the synthesis of the first representative of ACE inhibitors. They were supposed to be even more efficient than their predecessors. After all, ACE inhibitors block only the main pathway for the formation of angiotensin (there are others), and receptor blockers reduce the sensitivity of the vascular wall to a hormone of any origin.

The European Society of Hypertension, the European Society of Cardiology allows the appointment of sartans in a number of clinical situations that occur with an increase in blood pressure (3):

• left ventricular hypertrophy;
• violation of the kidneys;
• diseases of the cardiovascular system: stroke, myocardial infarction, heart failure;
• prevention of atrial fibrillation;
• diabetes.

The most reliable representatives of angiotensin II inhibitors:

• Valsartan is the very first, most studied sartan. Widely used since the mid 2000s. Well tolerated by most patients.
• Olmesartan is a newer drug for the treatment of hypertension. In some patients, it "works" better than valsartan.
• Fimasartan is a last-generation drug that lowers systolic and diastolic blood pressure well. It is especially effective for correcting high blood pressure in people with obesity (BMI over 30 kg/m2).

The basic list of side effects includes dizziness, headache, dry cough, sinusitis.

Sartans should not be prescribed to pregnant women, lactating women, children under 18 years of age, patients with renal artery stenosis.

What are sartans for arterial hypertension

Sartans belong to a group of inexpensive drugs that lower blood pressure. In individuals predisposed to hypertension, these drugs become an essential component of a stable life, greatly improving the prospects for longevity. The composition of the drug contains components that have a corrective effect on pressure throughout the day, they prevent the onset of hypertensive attacks and prevent the disease.

Herbal antihypertensives

Herbal medicines are considered the safest drugs that lower blood pressure. Due to their weak action, they are used to treat hypertension of the 1st degree. The most popular representative of this group is raunatin. It is obtained by processing the roots of rauwolfia. Raunatin normalizes blood pressure, has an antiarrhythmic effect. Its tablets are not suitable for people with coronary heart disease, myocardial damage, ulcers of the gastrointestinal tract, children, pregnant women, lactating women.

Combined drugs

Sartans are a class of antihypertensive drugs that reduce the sensitivity of receptors in the vessel wall, heart to the hormone angiotensin 2, which stimulates their contraction. This is one of the youngest groups of drugs that lower blood pressure. It was created as an alternative to ACE inhibitors, whose use is often accompanied by a complication - dry cough.

Consider the mechanism of action of sartans, the classification of ARBs, the main indications, contraindications, adverse reactions, features of drug interactions.

One of the main systems that regulate blood pressure (BP), the total volume of circulating blood, is called renin-angiotensin-aldosterone (RAAS). This is a complex chain of reactions, interactions of hormones of the liver, kidneys, adrenal glands, which regulates the tone of the vascular wall, the amount of water released. Under the influence of angiotensin-2, the arteries contract, which leads to a narrowing of their lumen, an increase in blood pressure.

In addition to the hypotensive effect, ARBs have a number of blood pressure-independent effects, which explains the need for the use of drugs for the treatment of diseases of the heart and kidneys.

Organoprotective, metabolic properties of the sartans group (5)

The group of sartans is represented by 4 subgroups of different chemical structure.

There are two generations of ARBs. Representatives of the first are valsartan, candesartan, losartan, olmesartan, eprosartan, irbesartan. All of them block only one type of receptor (AT-1). Second-generation sartans have two mechanisms of action: they inhibit angiotensin receptors, an activator of peroxisome proliferation y-type (PPAR-y). The latter governs:

• cell differentiation;
• metabolism of lipids, carbohydrates;
• sensitivity of adipose tissue to insulin;
• fatty acid oxidation.

The only second-generation ARB registered in Russia is telmisartan (Micardis). In addition to the properties typical for a group, it is much more efficient:

• prevents the development of atherosclerosis;
• reduces plasma concentration of triglycerides, glucose;
• normalizes the hormonal activity of the pancreas;
• improves metabolic parameters in diabetic patients;
• has an anti-inflammatory effect;
• smoothes some negative reactions from taking thiazide diuretics.

List of the most effective first generation sartans

Most often, sartans are prescribed as an antihypertensive agent for patients with arterial hypertension. Combining ARBs with other drugs is also effective for:

• chronic heart failure;
• nephropathy;
• microalbuminuria;
• thickening of the wall of the left ventricle;
• diabetes mellitus;
• metabolic syndrome;
• atherosclerosis;
• atrial fibrillation;
• myocardial infarction (only valsartan).

ARBs are first-line antihypertensives and are recommended to be given before other blood pressure-lowering pills. Primary candidates are patients in whom arterial hypertension is accompanied by:

• hypertrophy of the left ventricle or disruption of its work;
• chronic heart failure;
• excretion of albumin in the urine (albuminuria);
• diabetes mellitus;
• impaired renal function (creatinine clearance less than 60 ml / min);
• postinfarction cardiosclerosis;
• chronic renal failure (with intolerance to ACE inhibitors);
• as an alternative to ACE inhibitors, if a cough develops against the background of their use.

myocardial infarction

The only drug of the sartans group, which is recommended for patients after myocardial infarction, is valsartan. It is reliably known that it reduces mortality from a heart attack by 25%. A feature of the drug is its high specificity for AT1 receptors, which is 20 times higher than that of losartan (3).

The main advantages of sartans:

• minimum contraindications;
• are slowly excreted from the body: it is enough to take 1 time / day;
• very low chance of developing side effects;
• suitable for diabetics, the elderly, patients with kidney disease;
• do not cause cough;
• increase the life expectancy of patients with cardiovascular diseases;
• reduce the risk of stroke;
• unlike ACE inhibitors do not increase the risk of lung cancer.

The likelihood of developing negative reactions after taking sartans is very small. According to some studies, it is comparable to that of placebo. The most common complication is dizziness, associated with a decrease in pressure. To reduce discomfort, doctors recommend taking the pill at night.

Contraindications

• in case of hypersensitivity to the components of the drug or the active substance;
• during pregnancy, lactation.

Because of their proven adverse effects on the fetus, ARBs are not recommended for women of childbearing age who are not well protected. If an unplanned conception is detected, the drug is stopped.

Also, sartans are prescribed with caution:

• children;
• patients with a decrease in the total volume of circulating blood;
• bilateral stenosis of the renal arteries or narrowing of the artery of a single kidney;
• severe renal failure (creatinine clearance less than 10 ml / min);
• cirrhosis of the liver;
• obstruction of the biliary tract;
• along with drugs that retain potassium.

All sartans are well compatible with other types of drugs. They can be taken together with all known drugs for the treatment of cardiovascular diseases, diabetes. They enhance the hypotensive effect of other types of drugs that lower blood pressure, which must be taken into account when choosing a dose.

In 2010, the results of a large-scale analysis of several clinical studies were published. The authors found a pattern between ARB use and cancer risk. To test the findings of scientists, the US Food and Drug Administration, as well as several independent researchers, conducted their own analysis, which did not reveal a relationship between the use of sartans, an increase in the likelihood of cancerous tumors. Conversely, the use of ARBs reduced the chances of rectal neoplasms.

The question of the relationship between angiotensin receptor inhibitors and oncology has not yet been closed. However, do not be afraid of antihypertensive drugs. Even if the theory is confirmed not in their favor, this risk is extremely small, and the benefit is palpable. To prevent the development of cancer, it will be much more effective to fight other risk factors, rather than stop taking life-prolonging drugs.

Angiotensin-converting enzyme inhibitors (ACE inhibitors) are very similar in their mechanism of action to angiotensin II receptor blockers. They block the very reaction of converting angiotensin I to angiotensin II.

Later it turned out that this way of hormone formation is not the only possible one. According to a preliminary assessment, the use of sartans should have solved this problem. After all, they inactivate the sensitivity of angiotensin receptors of any origin. This would enhance the hypotensive effect. However, in practice, this assumption was not justified: another type of receptors was found in the body that were not affected by ARBs.

In addition to the hypotensive effect, ACE inhibitors, sartans have a number of additional properties that positively affect the dynamics of the course of diseases of the cardiovascular system and related disorders. However, the effect of the work of inhibitors is better studied, although in some diseases the appointment of angiotensin receptor blockers is more justified.

In the 2000s, several studies were published that showed an association between ARBs and a slight increase in the risk of heart attack. A more detailed study of this issue did not confirm or refute their conclusions, since the results were contradictory.

Mechanism of action

With oxygen starvation and a decrease in blood pressure, a special substance begins to form in the kidneys - renin, which transforms angiotensinogen into angiotensin I. Further, angiotensin I, under the influence of special enzymes, converts angiotensin II, which, adhering to receptors sensitive to this compound, causes hypertension. The drugs act on these receptors, preventing hypertensive tendencies.

A deep study of the pathological conditions of the cardiovascular system has made it possible to create receptor blockers for the angiotensin II provoking high blood pressure, known to patients as sartans for arterial hypertension. The main purpose of such drugs is to correct blood pressure, each jump of which brings the onset of serious problems with the heart, kidneys and brain vessels closer.

Contraindications to the use of sartans and side effects

Angiotensin receptor blockers have appeared on the market relatively recently. They should be taken as prescribed by the doctor in a dosage that depends on the individual characteristics of the patient. Drugs are used once a day, act for 24-48 hours. The persistent effect of sartans manifests itself after 4-6 weeks from the moment of treatment.

When using sartans for arterial hypertension, doctors note their good tolerance and the absence of specific side effects compared to other groups of drugs. Possible manifestations of a negative nature, according to reviews, are an allergic reaction, headache, dizziness, insomnia. Rarely noted fever, cough, sore throat, runny nose.

In some cases, pressure sartans can cause nausea, vomiting, constipation, and myalgia. Contraindications for the use of medicines are:

• pregnancy, breastfeeding, childhood due to lack of data on efficacy and safety;
• renal failure, stenosis of renal vessels, kidney disease, nephropathy;
• individual intolerance or hypersensitivity to the components.

Sartans for the treatment of arterial hypertension

Arterial hypertension is a stable increase in blood pressure, which varies between 145/95 mm Hg. Art., but can rise even higher. During the treatment of this disease, one should be extremely careful with the choice of drugs. As the practice of treatment has already shown, sartans for arterial hypertension can be considered the optimal and effective method.

The main task of angiotensin receptor blockers is to inhibit the activity of the RAAS, thus this process has a positive effect on the work of many human organs. Sartans are considered the best drugs on the list of high blood pressure drug groups. At the same time, it should be noted that the pricing policy of these drugs differs significantly from branded drugs - they have it more affordable.

These facts can only indicate that angiotensin receptor blockers have a minimal list of side effects, and some do not have them at all.

As far as confirmation or refutation of the fact that sartans cause cancer, this type of controversy is still under careful control.

Groups

According to chemical properties, ARBs can be divided into 4 subspecies:

• Biphenyls formed from tetrazole - Losartan, Irbesartan, Candesartan.
• Nebiphenol formed from tetrazole - Telmisartan.
• Non-biphenol netetrazoles - Eprosartan.
• Non-cyclic compounds - Valsartan.

This kind of drugs have been introduced into the treatment of arterial hypertension since the 1990s, and at the moment a rather considerable list of drugs can be noted:

• Losartan: Blocktran, Vasotenz, Zisakar, Karsartan, Cozaar, Lozap, Losarel, Losartan, Lorista, Losacor, Lotor, Presartan, Renicard,
• Eprosartan: Teveten,
• Valsartan: Valaar, Valz, Valsafors, Valsakor, Diovan, Nortivan, Tantordio, Tareg,
• Irbesartan: Aprovel, Ibertan, Irsar, Firmasta,
• Kandesartan: Angiakand, Atakand, Hyposart, Kandekor, Kandesar, Ordiss,
• Telmisartan: Micardis, Prytor,
• Olmesartan: Cardosal, Olimestra,
• Azilsartan: Edarbi.

In addition to the above, you can find from the classification of these drugs and combined components: with diuretics, with Ca antagonists, with aliskiren renin antagonists.

Angiotensin II receptor blockers give the highest effectiveness in diseases such as:

• arterial hypertension,
• insufficient performance of the heart muscle,
• myocardial infarction,
• Problems with the work of the cerebral blood system,
• Lack of glucose in the body
• nephropathy,
• Atherosclerosis,
• Disorders of a sexual nature.

Any of the drugs with antihypertensive effects is allowed to be prescribed, even in combination with other dosage forms. Type A-II drugs are often given when they are preferred. In this case, they can be considered better than ACE inhibitors at high blood pressure, sharp jumps in blood pressure.

Of the contraindications, the following types of population can be distinguished: women in position, lactation period, children's age from birth to 14 years. It is taken with caution in case of violations of the kidneys and liver.

Impact

ARBs are first and foremost effective blood pressure medications. But the result of therapy with these medicines can be different, depending on the degree of development of the disease. In the case when the pressure is stably elevated, A-II antagonists can show good efficacy.

Modern drugs - sartans are considered one of the best in terms of effects on such organs as the kidneys, heart, liver, brain, etc.

The main positive aspects in taking sartans can be considered:

• When taking this kind of drugs, an increase in heart rate was not noticed,
• With constant medication, pressure surges do not occur,
• With insufficient kidney function, under the influence of these drugs, there is a decrease in protein,
• Decreased levels of cholesterol, glucose, acid in the urine,
• Positive effect on the lipid process,
• Improving sexual ability,
• During the reception of sartans, a dry cough was not noticed.

It's important to know! During the course of an acute stroke, it is not recommended to use drugs to lower blood pressure for 5-8 days. An exception can only be excessively high pressure indicators.

You should also know that sartans have a beneficial effect on muscle tissue, especially good for those patients who have myodystrophy.

It's important to know! When a bilateral narrowing of the renal artery occurs, it is strictly forbidden to take drugs for Ara therapy - renal failure may develop.

It's important to know! During therapy, it is strictly forbidden to prescribe two or more types of sartans at the same time!

During the treatment of arterial hypertension, you should know the preferences of the drugs that cardiologists will prescribe to you:

• This kind of drugs can be used for more than a few years,
• Side effects in this case are either minimal or absent,
• In the treatment of arterial hypertension, tablets should be taken up to two times in 12 hours,
• The decrease in blood pressure does not occur abruptly, within 20-24 hours,
• With an already stable pressure (120/80), when taking sartans, the pressure will not decrease further,
• Patients do not get used to this kind of drugs,
• With a sharp non-use of drugs of this group, there will be no sharp pressure surges,
• Modern types of drugs have high efficiency and quality of administration during therapy and prevention.

Warning! After the first intake of blockers, do not expect a quick result. They are not capable of a rapid decrease in blood pressure, but they are able to bring it back to normal within 10-15 days, and a stronger effect after 20-25 days of administration.

Often, cardiologists insist on therapy with ARBs and diuretics.

Many pharmacies have a considerable number of pressure pills, which include sartans and diuretics:

• Atacand - 0.16 g Candesartan and 12.5 mg Hydrochlorothiazide,
• Co-diovan - 80 mg Valsartan and 12.5 mg Hydrochlorothiazide,
• Lorista - 12.5 mg Hydrochlorothiazide and 50-100 mg Losartan,
• Micardis - 80 mg Telmisartan and 12.5 mg Hydrochlorothiazide,
• Teveten - Eprosartan - 600 mg and 12.5 mg Hydrochlorothiazid.

In conclusion, I would like to note that according to medical studies, all of the above ARBs for arterial hypertension have a protective effect not only on the functioning of the heart, but also on many internal organs of a person, thereby reducing the risk of stroke, heart attack, heart failure, MBS and many other serious for life diseases.