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Journal of Renin-Angiotensin-Aldosterone System
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Review: Molecular-specific effects of angiotensin II antagonists: clinical relevance to treating hypertension?

John L Reid

Division of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, Scotland, UK, j.l.reid{at}clinmed.gla.ac.uk

Angiotensin II receptor blockers (ARBs) may produce a number of molecule-specific effects that appear to be independent of interaction with the angiotensin II type 1 (AT 1)-receptor. These include antagonism of the thromboxane A2 receptor, inhibition of platelet aggregation, induction of peroxisome proliferator-activated receptor gamma (PPAR{gamma}) activity, and reduction of serum uric acid levels. However, definitive evidence is lacking that these molecule-specific effects give rise to a therapeutic advantage of one ARB over another. Currently, the possibility of a link between a molecule-specific effect of an ARB and an improvement in clinical outcomes is best illustrated by a reduction in serum uric acid levels with losartan. Data from Losartan Intervention For Endpoint reduction in hypertension (LIFE) study suggest treatment-induced decrease in serum uric acid may contribute to the treatment benefit of a losaran-based versus atenolol-based therapy on the composite endpoint (death, myocardial infarction, or stroke). This finding should prompt further studies to investigate the long-term cardioprotective benefits issue of reducing hyperuricaemia in hypertensive patients.

Key Words: hypertension • angiotensin II antagonists • thromboxane A2 receptor • platelet aggregation • PPAR{gamma} • serum uric acid

References

Journal of Renin-Angiotensin-Aldosterone System, Vol. 6, No. 1, 15-24 (2005)
DOI: 10.3317/jraas.2005.002
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This Article
Right arrow Abstract Freely available
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Citing Articles
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Google Scholar
Right arrow Articles by Reid, J. L
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Reid, J. L
Right arrowPubmed/NCBI databases
*Compound via MeSH
*Substance via MeSH
Medline Plus Health Information
*Blood Thinners
*High Blood Pressure
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