Metabolic Effect of Treatment With Angiotensin-II Receptor Antagonists

The aim of treatment in hypertensive patients is not only to reduce blood pressure but also to minimize the overall cardiovascular risk. It is important, therefore, that the drugs administered have a beneficial influence on metabolic parameters as well as an anti hypertensive effect. It has been shown that angiotensin-II receptor antagonists (ARA IIs) are effective anti hypertensives that also have a positive influence on lipid and carbohydrate metabolism. Moreover, they can help prevent the development of new-onset diabetes. These actions arise from the blockade of angiotensin-II type-1 (AT-1) receptors, while some ARA IIs, though this does not appear to be a class effect, are also able to act like partial agonists of the nuclear receptor peroxisome proliferator-activated receptor-gamma (PPAR-A). If these beneficial metabolic effects, which have been found in experimental studies and in a few clinical studies, are confirmed in larger clinical trials, ARA IIs will become the ideal drugs for treating hypertensive patients with other cardiovascular risk factors or with metabolic syndrome.