Moderate elevations in blood pressure translate to significant increases in cardiovascular and cerebro vascular risk. Beneficially, this relationship allows small decreases in blood pressure to be associated with risk reduction. Both the renin-angiotensin system and the sympathetic nervous system are involved in
hypertension, hence targeting these systems is likely to be of benefit in the treatment of
hypertension.
Angiotensin II type 1 receptor blockers (ARBs) are used for controlling blood pressure and treating
heart failure in a broad range of patients, including those with diabetes and the elderly. Not only have ARBs shown good efficacy and tolerability, they also appear to have a protective effect that goes beyond that expected from the reduction of blood pressure. The ARB
eprosartan is a nonbiphenyl nontetrazole
angiotensin II type 1 receptor (AT1) antagonist, which acts to decrease total peripheral resistance.
Eprosartan acts at vascular AT1 receptors (postsynaptically) and at presynaptic AT1 receptors, where it inhibits
noradrenaline release. In clinical studies,
eprosartan has been shown to significantly reduce cardiovascular and cerebrovascular events, whilst avoiding the
persistent cough that commonly occurs with the use of
angiotensin-converting enzyme inhibitors.
Eprosartan can also be differentiated from other ARBs due to its noradrenergic effects, which other ARBs used at therapeutic doses do not possess.
Eprosartan, therefore, represents a useful therapeutic option in the management of patients with
hypertension, including those with a history of
stroke or with co-morbid
type 2 diabetes mellitus.