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. Functional and biochemical analysis of Angiotensin -forming pathways in the human heart. Circ Res ) Bauer JH, Reams GP. The Angiotensin type receptor antagonists A new class of antihypertensive durgs. Arch Intern Med ) Booz EW, Baker KM. Role of type 1 and type 2 Angiotensin receptors in Angiotensin -induced cardiomyocyte hypertrophy. Hypertension ) Dzau VJ, Mukoyama M, Pratt RE. Molecular biology and Angiotensin receptors Target for drug research? J hypertens S1-S5. 12) De Gasparo M, Husain A, Alexander W, et al. Proposed update of Angiotensin receptor nomenclature. Hypertension ) Haywood GA, Gullestad L, Katsuya T, et al. AT 1 and AT 2 Angiotensin receptor gene expression in human heart failure. Circulation ) Stoll M, Steckelings UM, Bottari SP, Unger T. Regulation of endothelial cell grwoth Role of the Angiotensin AT 2-receptor abstract. Circulation suppl ) Zhu YZ, Zhu YC, Chung O, Spitznagel H, Sandmann S, Unger J. Increased gene expression of Angiotensin AT1 and AT2 receptors in the acute phase of myocardial infarction abstract. Hypertension ) Stoll M, Steckelings UM, Paul M, Bottari SP, Metzger R, Unger T. The Angiotensin AT2 receptor mediates inhibition of cell proliferation in coronary endothelial cells. J Clin Invest ) Ford WR, Clanachan AS, Jugdutt BI. Opposite effects of Angiotensin AT 1 and AT 2 receptor antagonists on recovery of mechanical function after ischemia-reperfusion in isolated working rat hearts. Circulation ) Csajka C, Buclin T, Brunner HR, Biollaz J. Pharmacokinetic-pharmacodynamic profile of Angiotensin receptor antagonists. Clin Pharmacokinet ) Goodfriend TL, Elliott ME, Catt KJ. Angiotensin receptors and their antagonists. N Engl J Med ) Messerli FH, Weber MA, Brunner HR. Angiotensin receptor inhibition A new therapeutic principle. Arch Intern Med ) Gohlke P, Linz W, Schölkens BA, Wiemer G, Unger T. Cardiac and vascular effects of long-term losartan treatment in stroke-prone spontaneously hypertensive rats. Hypertension ) Richer-Giudicelli C, Fornes P, Cazaubon C, Nisato D, Giudicelli J-F. Effects of Angiotensin AT 1 receptor blockade on survival, systemic and coronary hemodynamics and cardiac remodeling in postischemic heart failure in rats. Circulation suppl ) van Kats JP, Danser AHJ, van Meegen JR, Sassen LMA, Verdouw PD, Schalekamp MADH. Angiotensin production in the heart. A quantitative study in pigs with the use of radiolabeled Angiotensin infusions. Circulation ) Man in t Veld AJ. Clinical overview of irbesartan Expanding the therapeutic window in hypertension. J Hypertens suppl 7S27-S33. 25) Dahlf B. The importance of the renin-angiotensin system in the reversal of left ventricular hypertrophy. J Hypertens suppl 3S29-S35. 26) Dahlf B. Effect of Angiotensin blockade on cardiac hypertrophy and remodelling A review. J Hum Hypertens 19959supplS37-S44. 27) Dahlf B, Penneri K, Hansson L. Reversal of left ventricular hypertrophy in Hypertensive Patients A Metaanalysis of 109 Treatment Studies. Am J Hypertens ) Kahan T, Malmqvist K, Edner M, Held C, Osbakken M. Rate and extent of left ventricular hypertrophy regression A comparison of Angiotensin blockade with irbesartan and beta-blockade abstrat. J Am Coll Cardiol A. 29) Kahan T. The importance of left ventricular hypertrophy in human hypertension. J Hypertens suppl 7 S23-S29. 30) Capers Q IVth, Laursen JB, Fukui T, Rajagopalan S, Mori I, Lou P, et al. Vascular thrombin receptor regulation in hypertensive rats. Circ Res ) Chobanian AV. Comparison of the effects of ACE inhibition and AT1 receptor blockade on atherosclerosis abstract. Am J Hypertens A. 32) Asano K, Dutcher DL, Port JD, et al. Selective downregulation of the Angiotensin AT 1-receptor subtype in failing human ventricular myocardium. Circulation ) Pitt B, Segal R, Martinez FA, Meurers G, Cowley AJ, Thomas I, et al. Randomized trial of losartan versus captopril in patients over 65 with heart failure Evaluation of Losartan in the Elderly Study. Lancet ) Vijay N, Alhaddad LA, Marty Denny D, Ruff D, Yasin M, Yellen L, et al. Irbesartan compared with lisinopril in patients with mild to moderate heart failure. J Am Coll Cardiol A. 35) Zierhut W, Studer R, Laurent D, et al. Left ventricular wall stress and sarcoplasmic reticulum Ca 2 -APTase gene expression in renal hypertensive rats Dose-dependent effects of ACE inhibition and AT1-receptor blockade. Cardiovasc Res Korean Circulation J 1999;293:

Treatment and Role of Hormaonal Replaement Therapy

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