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Angiotensin II-Receptor Blockers: Profile of a New Drug Class for Antihypertensive Therapy.

Of the population in the United States 65 years of age or older, more than half have high blood pressure. The benefits of treatment are well established, with decreased morbidity and mortality from stroke and MI. Antihypertensive therapy available for the elderly now includes losartan, the prototype of a new class of drugs, the angiotensin II-receptor blockers. The likelihood of even fewer side effects with the angiotensin II-receptor blockers than with ACE inhibitors promises to make them an important new therapy for elderly patients. Angiotensin II is the primary vasoactive component of the renin-angiotensin system, which is implicated in the pathophysiology of hypertension. Influencing this system pharmacologically has, therefore, important consequences for high blood pressure treatment. The ACE inhibitors have had success as antihypertensive agents, but they act early in the renin-angiotensin cascade, possibly leading to unwanted effects. The angiotensin II-receptor blockers act directly at the receptor level, thus avoiding the complications of interrupting the metabolic pathway early and disrupting other hormonal systems. These agents represent a new treatment option for hypertension in the elderly. Other clinical indications, such as heart failure and post-MI, are being investigated.