Patients with
hypertension do not comprise a homogeneous group, and the majority present with a variety of concomitant and associated conditions.
Antihypertensive therapies should therefore be effective and well tolerated in a wide range of patients and should, ideally, ameliorate the negative target-organ effects of
hypertension, such as
atherosclerosis, cardiovascular remodelling and renal impairment. Evidence is accumulating that the new
angiotensin II type 1 receptor blocker,
candesartan cilexetil, lowers blood pressure effectively and is well tolerated in a variety of patient groups, including women and the elderly. In patients with severe
hypertension, a treatment schedule based on
candesartan cilexetil, with the addition of
diuretic and
calcium antagonist
therapy as needed, has been found to control blood pressure successfully.
Candesartan cilexetil does not affect
glucose tolerance or
lipid profiles in patients with
diabetes mellitus, and it is not associated with any of the side effects of other
antihypertensive agents that would make it unsuitable for use in patients with
pulmonary disease. Initial clinical studies have indicated that
candesartan cilexetil is well tolerated and effective in patients with
heart failure. Furthermore, the available evidence shows that treatment with
candesartan cilexetil can reverse the negative effects of
hypertension on
left ventricular hypertrophy and microalbuminuria. It therefore appears that the pronounced efficacy and placebo-like tolerability of
candesartan cilexetil, as demonstrated in large clinical trials of patients with mild to moderate
hypertension, can be extended to a wide range of specific patient groups.