How do AT1-receptor blockers work?

According to the mechanism of action, angiotensin receptor blockers (BAR), as well as ACE inhibitors, affect the ReninAngiotensin system. However, this class works “more targeted”, since it removes the excess effects of angiotensin and aldosterone by blocking the at-receptors that these Pressor (blood PRESSURE-boosting) agents affect. THEY prevent the formation of angiotensin, a substance that causes vasoconstriction, and the vessels expand. As a result, blood pressure decreases.

What are AT1-receptor blockers?

Currently, there are a number of representatives of this group in the Arsenal of doctors. The most widely used was the first representative of this group – losartan. The effect of all drugs in this group is comparable in effectiveness and duration (up to 24 hours). Telmisartan has the longest action (up to 36 hours), allowing long-term control of blood PRESSURE. This drug has a number of other features, since it has a positive effect on carbohydrate metabolism, and preference should be given to it in diabetes mellitus. It is indicated for patients with kidney diseases.

What are AT1-receptor blockers good for?

AT1-receptor blockers have all the advantages of ACE inhibitors, are comparable to them in their ability to reduce blood PRESSURE and are almost devoid of side effects.

In which cases does the doctor prescribe AT1-receptor blockers?

Angiotensin receptor blockers are recommended to be taken 1 time a day. Angiotensin receptor blockers are a relatively new group of drugs, a number of major international studies have been completed, which have shown a favorable effect of losartan on the state of the heart muscle in patients with hypertension. The drug also showed a protective effect in kidney damage (kidney failure) in patients with diabetes mellitus. It is proved that irbesartan has a pronounced protective effect in patients with kidney damage in hypertension and diabetes mellitus (nephroprotective). Telmisartan occupies a special place among THEM, since this drug is indicated for the treatment of hypertension in patients with a high risk of cardiovascular complications and disorders of carbohydrate metabolism (diabetes mellitus, metabolic syndrome).

AT1-receptor blockers and sexual function

After one of the famous clinical studies of the 90s, publications appeared in the media that drugs that reduce blood pressure can have an effect on sexual function in men. In the pursuit of circulation and ratings, journalists did not think much about the consequences. Unfortunately, thanks to the media, the myth about the adverse effect of drug therapy on erection was born. When studying the results of this study in detail, it can be said that after 48 months of treatment, all classes of antihypertensive drugs that were compared with each other and with placebo (“dummy” – a substance without medicinal properties), it was proved that all classes of drugs are comparable in reducing blood PRESSURE. Unfortunately, over time, and with untreated or poorly treated hypertension, especially, erectile function decreases. The percentage of individuals with impaired potency by the end of this study was about 15-18 %, and was the same in both the treatment groups and the placebo group, that is, in those who did not receive proper medications that reduce blood PRESSURE. The incorrect interpretation gave rise to fears. According to the latest Russian statistics, the target blood PRESSURE figures are reached in 31 % of women and only 15 % of men, while the mortality rate for men in our country is very high, and its main cause is complications of untreated hypertension – stroke and myocardial infarction. Currently, there are a number of studies abroad and in Russia (including the author of this book) that the use of at 1-receptor blockers with regular intake not only effectively reduces blood PRESSURE, but also improves sexual function in both men and women.

When can I not prescribe AT1-receptor blockers?

AT1-receptor blockers should not be taken in pregnant women. They should not be taken with an increased content of potassium in the blood (hyperkalemia), narrowing (stenosis) of the renal arteries.

Be sure to tell your doctor:

• Whether you have taken AT1-receptor blockers, ACE inhibitors before, how you reacted to them, whether you were bothered by a dry cough.

• Whether you have detected changes in your kidneys or liver.

• You are pregnant or want to have a baby soon, what contraceptives you use.

How should I take AT1-receptor blockers?

Drugs of this group are taken once a day at the same time. It should be borne in mind that the effect (i.e. a steady decrease in blood pressure) does not occur immediately, but only after 2-3 weeks of continuous treatment.

What adverse reactions are possible when using AT1-receptor blockers?

Drugs of this group are usually very well tolerated. In most patients, no adverse reactions were observed when taking AT1-receptor blockers, so in most countries of the world, this class is becoming the leader in patients. In an extremely small percentage of cases, dizziness, urticaria, and itching may occur.

We have reviewed the main five classes of antihypertensive drugs. Below we will discuss the so-called auxiliary drugs that can be combined with drugs of the main classes.