Clinical efficacy and tolerability of candesartan cilexetil

Abstract

Clinical trials of candesartan cilexetil conducted in Japan are reviewed. Candesartan cilexetil inhibited the pressor response to intravenous angiotensin II in healthy volunteers, with peak effects observed at 4 or 8 h after oral dosing; suppressing effects persisted up to 24 h. In 14 multicentre studies with 928 hypertensive patients treated for 8 to 12 weeks, candesartan cilexetil had an efficacy rate (reduction of systolic/diastolic blood pressure у20/10 mm Hg and/or mean blood pressure у13 mm Hg) of 72% and 63%, and an adverse effect rate of 9.9% and 7.3%, in patients with mild-tomoderate essential hypertension and those with impaired renal function, respectively. When data for elderly patients were analysed, there was no difference in efficacy and tolerability compared to non-elderly patients. In a double-blind comparative study, candesar-

Clinical pharmacokinetics of angiotensin II (AT1) receptor blockers in hypertension

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15]21,25,29,35,43,60 The ARBs are effective and relatively safe in the elderly hypertensives, [2][3][4][5][6][7][8][9][10][11][12][13][14][15]42,52,63 and in patients with isolated systolic hypertension. 76 The antihypertensive efficacy of ARBs is enhanced when combined with diuretics, ACE inhibitors, calcium channel blockers, betablockers, or alpha-blockers.…”

“…76 The antihypertensive efficacy of ARBs is enhanced when combined with diuretics, ACE inhibitors, calcium channel blockers, betablockers, or alpha-blockers. [2][3][4][5][6][7][8][9][10][11][12][13][14][15]37,52,54,55,57 In combination with other classes of antihypertensive drugs, the ARBs are also efficacious in the treatment of JNC-VI Stage III (severe) hypertension. [77][78][79][80] In general, the blood pressure lowering efficacy of ARB monotherapy is lower in black than in white hypertensives.…”

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15]19,21,24,25,[31][32][33][36][37][38][39][40]42,44,47,50,54,56,[58][59][60]62 Sustained efficacy has been shown with long-term therapy with ARBs, with no tachyphylaxis. [36][37][38]42,47,48,50 Age or gender have no effect on blood pressure response to ARBs.…”

“…Angiotensin II receptor blockers (ARBs) represent a new class of effective and well tolerated orally active antihypertensive drugs [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] that inhibit the renin-angiotensin system by selectively blocking the AT 1 subtype of angiotensin II receptor. 1,16,17 A number of studies have demonstrated the efficacy of ARBs (used as monotherapeutic agents or in combination with other antihypertensive drugs) in the treatment of hypertension.…”

“…1,16,17 A number of studies have demonstrated the efficacy of ARBs (used as monotherapeutic agents or in combination with other antihypertensive drugs) in the treatment of hypertension. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Initial studies indicate that ARBs, either alone or in combination with angiotensin-converting enzyme (ACE) inhibitors, are also useful in the management of heart failure. [64][65][66][67][68][69][70][71][72][73][74][75] Several large, long-term studies are in progress (Table 1) to assess the beneficial effects of ARBs on cardiac hypertrophy, renal function, and cardiovascular and cerebrovascular morbidity and mortality in hypertensive patients with or without diabetes mellitus, and the value of these drugs in patients with heart failure, acute myocardial infarction, and diabetic nephropathy.…”