Review Article Korean Circulation J 1999;293:335-340 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
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;293:335-340
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
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 2 98.7 50100 E3174 69 99.8 qd to bid Candesartan 40 No Prodrug 99.5 216 qd CV-11974 9 Irbesartan 6080 No No 1115 90.0 150300 qd Tasosartan NA No Yes 37 NA NA Enoltasosartan 3443 Valsartan 25 4050% No 6 95.0 80320 qd 338 Korean Circulation J 1999;293:335-340
결 론 중심단어 339
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Korean Circulation J 1999;293:335-340