Angiotensin Ⅱ 수용체아유형 AT 1 수용체 Fig. 1. Pathway of Angiotensin ANG generation, site of actions of Angiotensin-coverting enzyme inhibitors ACEIs and Angi

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1 Review Article Korean Circulation J 1999;293: 고혈압과심혈관질환의치료에서 Angiotensin Receptor Antagonist 의역할 김권배 The Role of Angiotensin Receptor Antagonist in Patients with Hypertension and Cardiovascular Diseases Kwon-Bae Kim, MD Department of Internal Medicine, Keimyung University, School of Medicine, Taegu, Korea 서 론 국소 Renin-Angiotensin계 335

2 Angiotensin Ⅱ 수용체아유형 AT 1 수용체 Fig. 1. Pathway of Angiotensin ANG generation, site of actions of Angiotensin-coverting enzyme inhibitors ACEIs and Angiotensin receptor antagonists AT1RAs, and effects of Angiotensin binding to Angiotensin type 1 AT1 and type 2 AT2 receptors. The effects of AT1RAs on vascular tone and cell grwoth and differentiation may be the result of unopposed Angiotensin binding to the AT2 receptor. 336 Fig. 2. Short-and longterm changes consequent on binding at the Angiotensin receptor. Korean Circulation J 1999;293:

3 AT 2 수용체 RAS의억제 Table 1. Pharmacological effects of AT1 receptor blockers and ACE inhibitors AT1 receptor blockers ACE inhibitors AT1 stimulation AT2 stimulation Plasma renin activity Angiotensin levels Bradykinin levels 337

4 Table 2. Angiotensin receptor antagonistscomparative human pharmacokinetics Compound active metabolite Bioavailability % Food effect Active metabolite Half-life h Protein binding % Dosing mg Losartan 33 Minimal Yes E qd to bid Candesartan 40 No Prodrug qd CV Irbesartan 6080 No No qd Tasosartan NA No Yes 37 NA NA Enoltasosartan 3443 Valsartan % No qd 338 Korean Circulation J 1999;293:

5 결 론 중심단어 339

6 340 REFERENCES 1) Unger T, Chung O, Csikos T, Culman J, Gallinat S, Gohlke P, et al. Angiotensin receptors. J Hypertens supplS95-S103. 2) Unger T, Culman J, Gohlke P. Angiotensin receptor blockade and end-organ protection Pharmacological rationale and evidence. J Hypertens 16Suppl 7S3-S9. 3) McInnes G. Angiotensin antagonists. Science Press Ltd1998. p ) Daemen MJAP, Lombardi DM, Boaman FT, Schwartz SM. Angiotensin induces a smooth muscle cell proliferation in the normal and injured rat arterial wall. Circ Res ) Falkenhahn M, Franke F, Bohle RM, Zhu YC, Stauss I- IM, Bachmann S, et al. Cellular distribution of Angiotensin converting enzyme after myocardial infarction. Hypertension ) Unger T, Gohlke P, Paul M, Rettig R. Tissue renin- Angiotensin systems Fact or fiction? J Cardiovasc Pharmacol suppl 2S20-S25. 7) Husain A. The chymase-angiotensin system in humans Editorial review. J Hypertens ) Wolny A, Clozel J-P, Rein J, Mory P, Vogt P, Turino M, et al. 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Treatment and Role of Hormaonal Replaement Therapy

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