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Possible pathophysiologic mechanisms supporting the superior stroke protection of angiotensin receptor blockers compared to angiotensin-converting enzyme inhibitors: clinical and experimental evidence.
J Hum Hypertens. 2005 Dec; 19(12):923-31.JH

Abstract

Stroke is a major cause of death and disability and its incidence increases linearly with age and the level of systolic and diastolic blood pressure. Stroke, besides being a cause of long-term disability for the affected person, also imposes a significant burden on society and healthcare costs. Although good blood pressure control is very critical for stroke prevention, angiotensin receptor blockers (ARBs) may be superior to angiotensin-converting enzyme inhibitors (ACEIs) for the same degree of blood pressure control. This hypothesis has clinical and experimental support. ARBs prevent stroke incidence by blocking the angiotensin II (AII), AT1 receptors preventing brain ischaemia and allowing AII to stimulate the unoccupied AT2 receptors, which improve brain ischaemia. ACEIs, by reducing AII generation, are less effective in preventing stroke. This hypothesis provides evidence that AII plays an important role in the prevention of stroke. Certain ARBs like losartan, and telmisartan, irbesartan and candesartan possess additional properties which may play a role in stroke prevention, which is independent of AII. These include antiplatelet aggregating, hypouricemic, antidiabetic and atrial antifibrillatory effects. However, the most critical factor in stroke prevention is good blood pressure control irrespective of drug used.

Authors+Show Affiliations

Oklahoma Cardiovascular and Hypertension Center, Oklahoma City, OK 73132-4904, USA. schrysant@yahoo.com

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

16049519

Citation

Chrysant, S G.. "Possible Pathophysiologic Mechanisms Supporting the Superior Stroke Protection of Angiotensin Receptor Blockers Compared to Angiotensin-converting Enzyme Inhibitors: Clinical and Experimental Evidence." Journal of Human Hypertension, vol. 19, no. 12, 2005, pp. 923-31.
Chrysant SG. Possible pathophysiologic mechanisms supporting the superior stroke protection of angiotensin receptor blockers compared to angiotensin-converting enzyme inhibitors: clinical and experimental evidence. J Hum Hypertens. 2005;19(12):923-31.
Chrysant, S. G. (2005). Possible pathophysiologic mechanisms supporting the superior stroke protection of angiotensin receptor blockers compared to angiotensin-converting enzyme inhibitors: clinical and experimental evidence. Journal of Human Hypertension, 19(12), 923-31.
Chrysant SG. Possible Pathophysiologic Mechanisms Supporting the Superior Stroke Protection of Angiotensin Receptor Blockers Compared to Angiotensin-converting Enzyme Inhibitors: Clinical and Experimental Evidence. J Hum Hypertens. 2005;19(12):923-31. PubMed PMID: 16049519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Possible pathophysiologic mechanisms supporting the superior stroke protection of angiotensin receptor blockers compared to angiotensin-converting enzyme inhibitors: clinical and experimental evidence. A1 - Chrysant,S G, PY - 2005/7/29/pubmed PY - 2006/4/11/medline PY - 2005/7/29/entrez SP - 923 EP - 31 JF - Journal of human hypertension JO - J Hum Hypertens VL - 19 IS - 12 N2 - Stroke is a major cause of death and disability and its incidence increases linearly with age and the level of systolic and diastolic blood pressure. Stroke, besides being a cause of long-term disability for the affected person, also imposes a significant burden on society and healthcare costs. Although good blood pressure control is very critical for stroke prevention, angiotensin receptor blockers (ARBs) may be superior to angiotensin-converting enzyme inhibitors (ACEIs) for the same degree of blood pressure control. This hypothesis has clinical and experimental support. ARBs prevent stroke incidence by blocking the angiotensin II (AII), AT1 receptors preventing brain ischaemia and allowing AII to stimulate the unoccupied AT2 receptors, which improve brain ischaemia. ACEIs, by reducing AII generation, are less effective in preventing stroke. This hypothesis provides evidence that AII plays an important role in the prevention of stroke. Certain ARBs like losartan, and telmisartan, irbesartan and candesartan possess additional properties which may play a role in stroke prevention, which is independent of AII. These include antiplatelet aggregating, hypouricemic, antidiabetic and atrial antifibrillatory effects. However, the most critical factor in stroke prevention is good blood pressure control irrespective of drug used. SN - 0950-9240 UR - https://www.unboundmedicine.com/medline/citation/16049519/Possible_pathophysiologic_mechanisms_supporting_the_superior_stroke_protection_of_angiotensin_receptor_blockers_compared_to_angiotensin_converting_enzyme_inhibitors:_clinical_and_experimental_evidence_ L2 - http://dx.doi.org/10.1038/sj.jhh.1001916 DB - PRIME DP - Unbound Medicine ER -