rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2011-7-4-477-482rpcardio-865Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯSARTANS OF THE SECOND GENERATION: THERAPEUTIC POTENTIAL EXTENSIONСАРТАНЫ ВТОРОГО ПОКОЛЕНИЯ: РАСШИРЕНИЕ ТЕРАПЕВТИЧЕСКИХ ВОЗМОЖНОСТЕЙНедогодаС. В.NedogodaS. V.

д.м.н., профессор, заведующий кафедрой терапии и эндокринологии

 

nedogodasv@rambler.ruВолгоградский государственный медицинский университет.РоссияVolgograd State Medical UniversityRussian Federation20111901201674477482Copyright © Nedogoda S.V., 20162016Недогода С.В.Nedogoda S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/865

Peculiarities of the treatment with angiotensin II receptor blocker telmisartan are analyzed taking into account its clinical and pharmacological characteristics. Special attention is paid to the telmisartan benefits in comparison with other sartans. Key details of telmisartan interaction with peroxisome proliferator-activated receptors (PPAR) are discussed. Mode of this interaction distinguishes pharmacodynamic effects of different medicines. On the basis of presented data author concludes that antihypertensive therapy with telmisartan provides significant benefits.

Проанализированы особенности применения блокатора рецепторов ангиотензина II телмисартана с учетом его клинико-фармакологических характеристик. Особое внимание уделено преимуществам телмисартана перед другими сартанами. Подробно рассмотрены особенности взаимодействия телмисартана с рецепторами, активирующими пролиферацию пероксисом (peroxisome proliferator-activated receptors, PPAR). Характер взаимодействие с этими рецепторами лежит в основе фармакодинамических эффектов представителей различных групп лекарственных препаратов. С учетом представленных данных сделан вывод о существенных преимуществах антигипертензивной терапии с применением телмисартана.

 

телмисартанрецепторыактивирующие пролиферацию пероксисомартериальная гипертониясердечно-сосудистый рискtelmisartanperoxisome proliferator-activated receptorshypertensioncardiovascular riskReferencesKjeldsen S., Naditch-Brule L., Perlini S. et al. Increased prevalence of metabolic syndrome in uncontrolled hypertension across Europe: the Global Cardio-metabolic Risk Profile in Patients with hypertension disease survey. J Hypertens 2008; 26: 2064–70.Kjeldsen S., Naditch-Brule L., Perlini S. et al. Increased prevalence of metabolic syndrome in uncontrolled hypertension across Europe: the Global Cardio-metabolic Risk Profile in Patients with hypertension disease survey. J Hypertens 2008; 26: 2064–70.Ram C. Angiotensin receptor blockers: current status and future prospects. Am J Med 2008; 121: 656–63.Ram C. Angiotensin receptor blockers: current status and future prospects. Am J Med 2008; 121: 656–63.Nixon R.M., Muller E., Lowy A., Falvey H. Valsartan vs. other angiotensin II receptor blockers in the treatment of hypertension: a meta-analytical approach. Int J Clin Pract 2009; 63 (5): 766-775.Nixon R.M., Muller E., Lowy A., Falvey H. Valsartan vs. other angiotensin II receptor blockers in the treatment of hypertension: a meta-analytical approach. Int J Clin Pract 2009; 63 (5): 766-775.Song JC, White CM. Olmesartan medoxomil (CS-866). An angiotensin II receptor blocker for treatment of hypertension. Formulary 2001; 36: 487–499.Song JC, White CM. Olmesartan medoxomil (CS-866). An angiotensin II receptor blocker for treatment of hypertension. Formulary 2001; 36: 487–499.Sharpe M, Jarvis B, Goa KL. Telmisartan: a review of its use in hypertension. Drugs 2001;61(10):1501-29.Sharpe M, Jarvis B, Goa KL. Telmisartan: a review of its use in hypertension. Drugs 2001;61(10):1501-29.Burnier M, Brunner HR. Angiotensin II receptor antagonists. Lancet 2000;355(9204):637-45.Burnier M, Brunner HR. Angiotensin II receptor antagonists. Lancet 2000;355(9204):637-45.Brunner HR. The new oral angiotensin II antagonist olmesartan medoxomil: a concise overview. J Hum Hypertens 2002;16 Suppl 2:S13-6.Brunner HR. The new oral angiotensin II antagonist olmesartan medoxomil: a concise overview. J Hum Hypertens 2002;16 Suppl 2:S13-6.Differences Among Angiotensin II Receptor Blockers. US Pharm 2004;10:HS19- HS25.Differences Among Angiotensin II Receptor Blockers. US Pharm 2004;10:HS19- HS25.Kakuta H et al. Telmisartan has the strongest binding affinity to angiotensin II type 1 receptor: comparison with other angiotensin II type 1 receptor blockers. Int J Clin Pharmacol Res 2005; 25: 41–51.Kakuta H et al. Telmisartan has the strongest binding affinity to angiotensin II type 1 receptor: comparison with other angiotensin II type 1 receptor blockers. Int J Clin Pharmacol Res 2005; 25: 41–51.Nedogoda S.V. Hyperuricaemia and kidney damage in patients with hypertension and metabolic syndrome. Quality of life. Kachestvo zhizni. Meditsina 2008; 3: 16-27. Russian (Недогода С.В. Гиперурикемия и поражение почек у больных с артериальной гипертензией и метаболическим синдромом. Качество жизни. Медицина 2008; 3: 16-27).Nedogoda S.V. Hyperuricaemia and kidney damage in patients with hypertension and metabolic syndrome. Quality of life. Kachestvo zhizni. Meditsina 2008; 3: 16-27. Russian (Недогода С.В. Гиперурикемия и поражение почек у больных с артериальной гипертензией и метаболическим синдромом. Качество жизни. Медицина 2008; 3: 16-27).Benson S, Pershadsingh H, Ho C et al. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARgammamodulating activity. Hypertension 2004; 43 (5): 993–1002.Benson S, Pershadsingh H, Ho C et al. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARgammamodulating activity. Hypertension 2004; 43 (5): 993–1002.Schupp M., Janke J., Clasen R. et al. Angiotensin type 1 receptor blockers induce peroxisome proliferator-activated receptor-gamma activity. Circulation 2004; 109: 2054–7.Schupp M., Janke J., Clasen R. et al. Angiotensin type 1 receptor blockers induce peroxisome proliferator-activated receptor-gamma activity. Circulation 2004; 109: 2054–7.Babaev V., Ishiguro H., Ding L. et al. Macrophage expression of peroxisome proliferator-activated receptor α reduces atherosclerosis in low density lipoprotein receptor deficient mice. Circulation 2007; 116: 1404–1412.Babaev V., Ishiguro H., Ding L. et al. Macrophage expression of peroxisome proliferator-activated receptor α reduces atherosclerosis in low density lipoprotein receptor deficient mice. Circulation 2007; 116: 1404–1412.Cresci S. PPAR genomics and pharmacogenomics: implications for cardiovascular disease. PPAR Res 2008;2008:374549.Cresci S. PPAR genomics and pharmacogenomics: implications for cardiovascular disease. PPAR Res 2008;2008:374549.Duan S.Z., Ivashchenko C.Y., Russell M.W. et al.Cardiomyocyte-specffic knockout and agonist of per-oxisome proliferator-aVolctivated receptor-γ both induce cardiac hypertrophy in mice. Circulation Research 2005; 97(4): 372–379.Duan S.Z., Ivashchenko C.Y., Russell M.W. et al.Cardiomyocyte-specffic knockout and agonist of per-oxisome proliferator-aVolctivated receptor-γ both induce cardiac hypertrophy in mice. Circulation Research 2005; 97(4): 372–379.Beltowski J. Role of leptin in blood pressure regulation and arterial hypertension. J Hypertens 2006; 5:789–801.Beltowski J. Role of leptin in blood pressure regulation and arterial hypertension. J Hypertens 2006; 5:789–801.Fogo A.B. Potential for peroxisome proliferatoractivated receptor-[gamma] agonists in progression: beyond metabolism. Current Opinion in Nephrology and Hypertension 2008; 17(3):282–285.Fogo A.B. Potential for peroxisome proliferatoractivated receptor-[gamma] agonists in progression: beyond metabolism. Current Opinion in Nephrology and Hypertension 2008; 17(3):282–285.Kurtz T.W. Beyond the classic angiotensin-receptor blocker profile. Nature Reviews Cardiology 2008;5:S19–S26.Kurtz T.W. Beyond the classic angiotensin-receptor blocker profile. Nature Reviews Cardiology 2008;5:S19–S26.Kurtz T., Klein U. Next generation multifunctional angiotensin receptor blockers. Hypertens Res 2009; 32 (10): 826–34.Kurtz T., Klein U. Next generation multifunctional angiotensin receptor blockers. Hypertens Res 2009; 32 (10): 826–34.Bagry H.S., Raghavendram S., Carli F. Metabolic syndrome and insulin resistance. Anesthesiology 2008;108(3):506–523.Bagry H.S., Raghavendram S., Carli F. Metabolic syndrome and insulin resistance. Anesthesiology 2008;108(3):506–523.Leone T., Weinheimer C., Kelly D. A critical role for the peroxisome proliferator-activated receptor α (PPARα) in the cellular fasting response: the PPARα-null mouse as a model of fatty acid oxidation disorders. Proc Natl Acad Sci USA 1999; 96: 7473–7478.Leone T., Weinheimer C., Kelly D. A critical role for the peroxisome proliferator-activated receptor α (PPARα) in the cellular fasting response: the PPARα-null mouse as a model of fatty acid oxidation disorders. Proc Natl Acad Sci USA 1999; 96: 7473–7478.Li X., Hansen P.A., Xi L. et al. Distinct mechanisms of glucose lowering by specific agonists for per-oxisomal proliferator activated receptor gamma and retinoic acid X receptors. J Biol Chem 2005; 280(46): 38317–38327.Li X., Hansen P.A., Xi L. et al. Distinct mechanisms of glucose lowering by specific agonists for per-oxisomal proliferator activated receptor gamma and retinoic acid X receptors. J Biol Chem 2005; 280(46): 38317–38327.Sugimoto K., Qi N.R., Kazdová L. et al. Telmisartan but not valsartan increases caloric expenditure and protects against weight gain and hepatic steatosis. Hypertension 2006;47(5):1003-9.Sugimoto K., Qi N.R., Kazdová L. et al. Telmisartan but not valsartan increases caloric expenditure and protects against weight gain and hepatic steatosis. Hypertension 2006;47(5):1003-9.Matchar D.B., McCrory D.C., Orlando L.A. et al. Systematic Review: Comparative Effectiveness of An-giotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension. Ann Intern Med 2008;148:16–29.Matchar D.B., McCrory D.C., Orlando L.A. et al. Systematic Review: Comparative Effectiveness of An-giotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension. Ann Intern Med 2008;148:16–29.Quinn C.E., Hamilton P.K., Lockhart C.J. Thiazolidinediones: effects on insulin resistance and the cardiovascular system. British J Pharmacology 2008; 153: 636–645.Quinn C.E., Hamilton P.K., Lockhart C.J. Thiazolidinediones: effects on insulin resistance and the cardiovascular system. British J Pharmacology 2008; 153: 636–645.Miura Y., Yamamoto N., Tsunekawa S. et al. Metabolic Effects of Replacing Valsartan or Candesartan by Telmisartan. Diabetes Care 2005; 28(3): 757–8.Miura Y., Yamamoto N., Tsunekawa S. et al. Metabolic Effects of Replacing Valsartan or Candesartan by Telmisartan. Diabetes Care 2005; 28(3): 757–8.Vitale C., Mercuro G., Castiglioni C. Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome. Cardiovasc Diabetol 2005;4:6.Vitale C., Mercuro G., Castiglioni C. Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome. Cardiovasc Diabetol 2005;4:6.Derosa G., Ragonesi P.D., Mugellini A. et al. Effects of telmisartan compared with eprosartan on blood pressure control, glucose metabolism and lipid profile in hypertensive, type 2 diabetic patients: a ran-domized, double-blind, placebo-controlled 12-month study. Hypertens Res 2004;27(7):457-64.Derosa G., Ragonesi P.D., Mugellini A. et al. Effects of telmisartan compared with eprosartan on blood pressure control, glucose metabolism and lipid profile in hypertensive, type 2 diabetic patients: a ran-domized, double-blind, placebo-controlled 12-month study. Hypertens Res 2004;27(7):457-64.van Zwieten P.A. Angiotensin II receptor antagonists (AT1-blockers, ARBs, sartans): similarities and differences. Neth Heart J 2006; 14(11):381–387.van Zwieten P.A. Angiotensin II receptor antagonists (AT1-blockers, ARBs, sartans): similarities and differences. Neth Heart J 2006; 14(11):381–387.Sugawara A., Takeuchi K., Uruno A. at al. Negative regulation of rat thromboxane receptor gene by 15- deoxy-D12, 14-PGJ2 and troglitazone by activating PPAR-g in vascular smooth muscle cells. J Am Soc Nephrol 1998; 9: 358A.Sugawara A., Takeuchi K., Uruno A. at al. Negative regulation of rat thromboxane receptor gene by 15- deoxy-D12, 14-PGJ2 and troglitazone by activating PPAR-g in vascular smooth muscle cells. J Am Soc Nephrol 1998; 9: 358A.Ayuko Nakano, Yoshiyuki Hattori, Chie Aoki et al. Telmisartan inhibits cytokine-induced nuclear factor-kB activation independently of the peroxisomeproliferators-activated receptor-α. Hypertension Research 2009;32: 765–769.Ayuko Nakano, Yoshiyuki Hattori, Chie Aoki et al. Telmisartan inhibits cytokine-induced nuclear factor-kB activation independently of the peroxisomeproliferators-activated receptor-α. Hypertension Research 2009;32: 765–769.McGill J.B., Reilly P.A. Telmisartan plus hydrochlorothiazide versus telmisartan or hydrochlorothiazide monotherapy in patients with mild to moderate hypertension: a multicenter, randomized, double-blind, placebo-controlled, parallel-group trial. Clin Ther 2001;23(6):833-50.McGill J.B., Reilly P.A. Telmisartan plus hydrochlorothiazide versus telmisartan or hydrochlorothiazide monotherapy in patients with mild to moderate hypertension: a multicenter, randomized, double-blind, placebo-controlled, parallel-group trial. Clin Ther 2001;23(6):833-50.Sharma A., Davidson J., Koval S., Lacourcière Y. Telmisartan/hydrochlorothiazide versus valsar-tan/hydrochlorothiazide in obese hypertensive patients with type 2 diabetes: the SMOOTH study. Cardiovascular Diabetology 2007; 6:28-36.Sharma A., Davidson J., Koval S., Lacourcière Y. Telmisartan/hydrochlorothiazide versus valsar-tan/hydrochlorothiazide in obese hypertensive patients with type 2 diabetes: the SMOOTH study. Cardiovascular Diabetology 2007; 6:28-36.Hsueh W.A., Quinones M.J. Role of endothelial dysfunction in insulin resistance. Am J Cardiol 2003;92:10J–17J.Hsueh W.A., Quinones M.J. Role of endothelial dysfunction in insulin resistance. Am J Cardiol 2003;92:10J–17J.Yusuf S., Teo K., Anderson C. et al. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomized controlled trial. Lancet 2008; 372: 1174–83.Yusuf S., Teo K., Anderson C. et al. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomized controlled trial. Lancet 2008; 372: 1174–83.Yusuf S., Diener H., Sacco R. et al. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 2008; 359: 1225–37.Yusuf S., Diener H., Sacco R. et al. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 2008; 359: 1225–37.

The authors declare that there are no conflicts of interest present.