2014, Número 3
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Enf Neurol (Mex) 2014; 13 (3)
Farmacoepidemiología de los fármacos antagonistas de los receptores de angiotensina (ARA) II en el tratamiento de la hipertensión arterial esencial. México
Alba-Leonel A, Fajardo-Ortiz G, Papaqui-HJ
Idioma: Español
Referencias bibliográficas: 68
Paginas: 139-146
Archivo PDF: 274.08 Kb.
RESUMEN
Epidemiología de la hipertensión arterial: A nivel mundial, se reporta que la prevalencia de hipertensión arterial en población adulta se encuentra entre un 20-27%.
Tratamiento farmacológico: Los ARA II ejercen su acción a través del bloqueo de los receptores AT1 de la angiotensina II de forma específica y altamente selectiva y actúan inhibiendo los efectos clásicos desfavorables de angiotensina II. Así, los ARA II antagonizan la acción de la angiotensina II producida por cualquier vía enzimática y no actúan sobre la degradación de las quininas, por lo que no condicionan un aumento de sus niveles en sangre. Además, al bloquear los receptores ATI los ARA II permiten que la angiotensina II circulante se pueda ligar a los receptores AT2, lo que puede añadir un efecto adicional potencialmente muy beneficioso.
Estudios de morbimortalidad en Hipertensión con ARA II: La eficacia de los ARA II para disminuir la tensión arterial está demostrada desde hace varios años, tanto en HTA leve como moderada o severa, y en múltiples estudios comparativos estos fármacos muestran una eficacia antihipertensiva similar a la de los IECAS, antagonistas del calcio o betabloqueantes. Por tanto, ante una eficacia antihipertensiva similar y un mejor perfil de tolerabilidad, los ARA II pueden considerarse una familia farmacológica de gran utilidad en el tratamiento actual de la HTA.
Conclusiones: La conclusión de los autores de diversos estudios es que los IECA y los ARA-II tienen una efectividad antihipertensiva similar y los IECA, una peor tolerabilidad.
REFERENCIAS (EN ESTE ARTÍCULO)
Organización Mundial de la Salud [OMS]. (2013). Global Health Observatory. Raised blood pressure. Situation and trends. de: http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/index.html, recuperado el 01 enero de 2014.
Organización Mundial de la Salud [OMS]. (2012). ¿Es la hipertensión un problema frecuente?., de: http://new.paho.org/col/index.php?option=com_content&view=article&id=190:historia-del-dia-mundial-de-la-salud&catid=794&Itemid=500,Organización Mundial de la Salud [OMS].(2012). ¿Es la hipertensión un problema frecuente? Recuperado el 15 de febrero de 2014.
Velázquez Monroy O et al. Hipertensión arterial en México: Resultados de la Encuesta Nacional de Salud (ENSA) 2000. Arch Clin Mex. 2002; 72 (1): 71-84.
Jones DW, Appel LJ, Sheps SG, Roccella EJ, Lefant C. Measuring blood pressure accurately. New and Persistent Challenges. JAMA. 2003; 289 (8): 1027-1030.
Santos-Preciado JI, Villa-Barragán JP, García-Avilés MA et al. La transición epidemiológica de las y los adolescentes en México. Rev Sal Pub Mex. 2003; 45 (S1): S140-S152.
Omram AR. The epidemiology transition theory a preliminary. J Trop Pediatr. 1983; 29: 305-316.
Delgado RA, Fagundo MF, López LE et al. Transición epidemiológica. Rev Med Electrónica, Facultad de Ciencias Médicas, Matanzas, Cuba. 2003; 25 (1:1-6), tema 3 ene-feb. Recuperado 12 de enero de 2014.
Organización Mundial de la Salud [OMS]. (2002). Cuantificación de algunos riesgos importantes para la salud. En Informe Sobre la Salud en el Mundo 2002. Reducir los riesgos y promover una vida sana. http://www.who.int/whr/2002. Recuperado el 14 de febrero de 2014.
Martínez-Palomino G, Vallejo-Allende M, Huesca C, Álvarez de León E, Paredes G, Factores de riesgo cardiovascular en una muestra de mujeres jóvenes mexicanas, Rev Arch Cardiol Mex. 2006; 76 (4): 401-407.
Secretaría de Salud, México. Instituto Nacional de Salud Pública, Encuesta Nacional de Salud 2000, Tomo 2. La Salud de los Adultos, México, D.F., 2003:106-107.
Barquera S., Campos N. Ismael, Hernández B. L.,et al. Hypertension in Mexican adults: results from the National Health and Nutrition Survey 2006. Salud Publica Mex 2010 Vol 52: Suplemento I S63-S71.
Instituto Nacional de Salud Pública [INSP]. [2012). Encuesta Nacional de Salud y Nutrición (ENSANUT) 2012. http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf, Recuperado el 14 de febrero de 2014.
DGAE/DIE/SS, 2013. Comportamiento de la mortalidad en México 1995, 2000 y 2012.
Huerta RB, Factores de riesgo para la hipertensión arterial. Rev Arch de Cardiol de Mex. 2001; 71 (S1): S208-S210.
Ruilope LM, Barrios V. Pharmacologic treatment in hypertensive heart disease. In: Crawford MH, Di Marco JP eds. Cardiology. London: Mosby, 2001; 8.1-8.8.
lsraili ZH, Hall WD. Cough and angioneurotic edema associated with angiotensin-converting-enzyme inhibitor therapy: a review of the literature and pathophysiology. Am Intern Med. 1992; 117: 234-242.
Bloom BS. Continuation of initial antihypertensive medication after 1 year of therapy. Clin Ther. 1998; 20: 671-681.
Conlin PR, Gerth WC, Fox J, Roehm JB, Boccuzzi SJ. Four-year persistence patterns among patients initiating theraphy with the angiotensina II receptor antagonist losartan versus other antihypertensive drug classes. Clin Ther. 2001; 23: 1999-2010.
Paster RZ, Snavely DB, Swett AR, Draper RA, Goldberg Al, Soffer BA et al. Use of losartan in the treatment of hypertensive patients with a history of cough induced by angiotensin-converting-enzyme inhibitors. Clin Ther. 1998; 20: 978-989.
Black HR, Graff A, Shute D, Stoltz R, Ruff D, Levine J et al. Valsartan, a new angiotensin II antagonist of the treatment of essential hypertension. Efficacy, tolerability and safety compared to an angiotensin inhibitor. lisinopril. J Hum Hypertens. 1997; 11: 483-489.
Belcher G, Hubner R, George M, Elmfeldt D, lunde H: Candersartan cilexetil: Safety and tolerability in healthy volunteers and patients with hypertension. J Hum Hypertens. 1997; 11: 585-589.
Barrios V, Navarro A, Esteras A, Luque M, Romero J, Tamargo J et al. Antihypertensive efficacy and tolerability of lercarnidipine in daily clinical practice. The ELYPSE study. Blood Pressure. 2002; 11: 95-100.
Sever R. Candersartan cilexetil: a new, long-acting, effective angiotensin in type 1 receptor blocker. J Hum Hypertens. 1997; 11 (Suppl 2): 591-595.
Johnston CL. Angiotensin receptor antagonist: focus on losartan. Lancet. 1995; 346: 1403-1407.
Gillis JC, Markham A. Irbesartan: A review oí its pharmacodynamic and pharmacokinetic properties and therapeutic use in the management of hypertension. Drugs. 1997; 54: 885-890.
Markham A, Goa KL. Valsartan: a review of its pharmacology and therapeutic use in essential hypertension. Drugs. 1997; 54: 299-311.
Black HR, Graff A, Shute D, Stoiz R, Ruff D, Levine J et al. Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension. Efficacy, tolerability and safety compared to an angiotensin- converting enzyme inhibitor, lisinopril. J Hum Hypertens. 1997; 11: 483-489.
Tikkanen I, Omvik P, Jensen HA, for the Scandinavian Study Group: Comparison of the angiotensin II antagonist losartan with the angiotensin converting enzyme inhibitor enalapril in patients with essential hypertension. J Hypertens. 1995; 13: 1343-1351.
Mimran A, Ruilope LM, Kerwin L, Nys M, Owens D, Kassler-Taub K et al. A randomised, double blind comparison of the angiotensin II receptor antagonist irbesartan, with the full dose range of enalapril for the treatment of mild-to-moderate hypertension. J Hum Hypertens. 1998; 12: 203-208.
Kariberg BE, Lins LE, Hermansson K, for the TEES Study Group. Efficacy and Safety of Telmisartan a selectiva AT I receptor antagonist, compared with enalapril in ederly patients with Primary hypertension. J Hypertens. 1999; 17: 293-302.
Dahiof B, Keller S, Makris L, Goldberg AL, Sweet CS, Lim NY. Efficacy and tolerability of losartan potassium and atenolol in patients with mild or moderate essential hypertension. Am J Hypertens. 1995; 8: 578-583.
Corea L, Cardoni O, Fogari R, Innocenti P, Porcellati C, Providenza M et al. Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension. A comparative study of the efficacy and safety agonist amiodipine. Clin Pharm Ther. 1996; 60: 341-346.
Lombera F, Barrios V, Soria F, Placer L, Cruz JM, Tomás L et al. Guías de práctica clínica de la Sociedad Española de Cardiología en hipertensión arterial. Rev Esp Cardiol. 2000; 53: 66-90.
Guidelines Subcommittee. 1999 World Health Organization lnternational Society of Hypertension guidelines for the management of hypertension. J Hypertens. 1999; 17: 151-183.
American Diabetes Association. Diabetic nephropathy. Diabetes Care. 2002; 25 (Suppl): S85-S89.
Kassier-Taub K, Little John T, Elliott W, Ruddy T, AdLer E. Comparative efficacy of two angiotensin II receptor antagonists, irbersartan and losartan, in mild to moderate hypertension. Am J Hypertens. 1998; 11: 445-453.
Andersson OK, Neldom S. The antihypertensive effect and tolerability of candersartan cilexetil, a new generation angiotensin II antagonist, in comparison with losartan. Blood Press. 1998; 7: 53-59.
Oparil S. Comparative antihypertensive efficacy of olmesartan: comparison with other angiotensin II receptor antagonists. J Hum Hypertens. 2002; 16 (suppl 2): 17-23.
Conlin P, Spence B, Ribeiro A, Saito I, Benedict C, Bunt M. Angiotensin II antagonist for hypertension: Are there differences in efficacy? Am J Hypertens 2000; 13: 418-426.
Hansson L, Lindhoim LH, Niskanen L, Lanke J, Hedner T, Niklason A et al. Effect angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: Captopril Prevention Project (CAPPP) randomised trial. Lancet. 1999; 353: 611-616.
Brown MJ, Palmer CR, Castaigne A, de Leeuw PW et al. Mordidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the internacional Nifedipine GITS study: Intervention as a goal in hypertension Treatment (INSIGHT). Lancet. 2000; 356: 366-372.
Hansson L, Hedner T, Lund-Johansen P, Kjeidsen S, Lindhoim LH, Syvertsen JO et al. Randomised trial of effects of calcium antagonists compared with diuretics and Beta-blockers on cardiocascular morbidity and morbility in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet. 2000; 356: 359-365.
Hansson L, Lindholm LH, Ekbom T, Dahiof B, Lanke J, Schersten B et al. Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2-study. Lancet. 1999; 354: 1751-1756.
Lewis EJ, Hunsicker LG, Ciarke WR, Beri T, Pohi MA, Lewis JB et al. Collaborative Study Group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001; 345: 851-860.
Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Eng J Med. 2001; 345: 861-869.
Dahlof B, Devereux RB, Kjeidsen SE et al. Cardiovascular morbidity and mortality in the losartan intervention for endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002; 359: 995-1003.
Dahlof B, Devereux RV, Julius S et al. Characteristics of 9,194 patients with left ventricular hypertrophy: the LIFE study. Hypertension. 1998; 32: 989-997.
Dahlof B, Devereux RB, de Faire U et al The losartan lntervention For Endpoint reduction (LIFE) in hypertension study: rationale, design, and methods. Am J Hypertens. 1997; 10: 705-713.
Dahlof B, Keller SE, Makris L, Goldberg Al, Sweet CS et al. Efficacy and tolerability of losartan potassium and atenolol in patients with mild to moderate essential hypertension. Am J Hypertens. 1995; 8: 578-583.
Dahlof B, Lindhoim LH, Hansson L, Schersten B, Ekbom T, Wester PO. Morbidity and mortality in the swedish trial in old patients with hypertension (STOP-Hypertension). Lancet. 1991; 338: 1281-1285.
Kjeldsen SE, Dahlof B, Devereux RB, Julius S et al, for the LIFE Study Group. lowering of blood pressure and predictors of response in patients with left ventricular hypertrophy: the LIFE Study. Am J Hypertens. 2000; 13: 899-906.
Lindholm LH, lbsen H, Dahlof B, Devereux RB et al. Cardiovascular morbidity and mortality in diabetics patients of the LIFE study: a randomised trial against atenolol. Lancet. 2002; 359: 1004-1010.
UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. BMJ. 1998; 317: 713-720.
Kjeldsen S, Dahlof B, Devereux R, Julius S, Aurup P et al, for the LIFE study. Effects of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy. A Losartan lntervention For Endpoint Reduction (LIFE) Substudy. JAMA. 2002; 288: 1491-1498.
Devereux RB, Palmieri B, Liu J et al. Progressive hypertrophy regression with sustained pressure reduction in hypertension: the Losartan lntervention For Endpoint Reduction Study. J Hypertens. 2002; 20: 1445-1450.
Dahiof B, Zanchetti A, Diez J et al. Effects of losartan and atenolol on left ventricular mass and neurhormonal profile in patients with essential hypertension and left ventricular hypertrophy. J Hypertens. 2002; 20: 1855-1864.
Wachtell K. Change in systolic left ventricular performance after 3 years of antihypertensive treatment: LIFE Study. Circulation. 2002; 106: 227-232.
Wachtell K. Change in diastolic left ventricular filling after one year of antihypertensive treatment: LIFE Study. Circulation. 2002; 105: 1071-1076.
Gerdts E. Correlates of pulse pressure reduction during antihypertensive treatment (losartan or atenolol) in hypertensive patients with electrocardiographic left ventricular hypertrophy (the LIFE Study). Am J Cardiol. 2002; 89: 399-402.
Gerdts E. Correlates of left atrial size in hypertensive patients with left ventricular hypertrophy: LIFE Study. Hypertension. 2002; 39: 739-743.
Wachtell K. Microalbuminuria in hypertensive patients with electrocardiographic left ventricular hypertrophy: the LIFE Study. J Hypertens. 2002; 20: 405-412.
Brunner HR, Gavras H. Angiotensin blockade for hypertension: a promise fulfilled. Lancet. 2002; 359: 990-992.
Barrios V, Campuzano R, Peña G et al. Estratificación del riesgo cardiovascular en hipertensión en Atención Primaria e impacto sobre el tratamiento antihipertensivo. Estudio DIORISC. Hipertensión. 2002; 19: 114-120.
Parving HH, Lehnert H, Brochner-Mortensen J, Gomis R, Andersen S, Arner P. lrbesartan in patients with type 2 diabetes and microalbuminuria study group. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. 2001; 345: 870-878.
Hansson L, Lithell H, Skoog L et al. Study on cognition and prognosis in the elderly (SCOPE): baseline characteristics. Blood Press. 2000; 9: 146-151.
Mann J, Julius 5, for the VALUE Trial Group. The Valsartan Antihypertensive long-term. Use evaluation (VALUE) trial of cardiovascular events in hypertension. Rationale and design. Blood Press. 1998; 7: 176-183.
Kjeldsen SE, Julius S, Brunner H et al. A. Characteristics of 15314 hypertensive patients at high coronary risk. The VALUE trial. The Valsartan Antihypertensive Long-term Use Evaluation. Blood Press. 2001; 10: 83-91.
Anastacio GD, Cornell KO, Menscer D. Drug interactions: Keeping it straight. Am Fam Physician. 2002; 66 (3): 461-468.