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The role of renin-angiotensin system inhibition in the treatment of hypertension in metabolic syndrome: are all the angiotensin receptor blockers equal?

机译:抑制肾素-血管紧张素系统在代谢综合征高血压中的作用:所有血管紧张素受体阻滞剂是否均等?

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摘要

The metabolic syndrome (MetS) is a strong predictor of cardiovascular morbidity and mortality, as well as new Type 2 diabetes. MetS consists of visceral obesity, elevated blood pressure, impaired glucose metabolism, atherogenic dyslipidaemia (elevated triglycerides and low levels of high-density lipoprotein cholesterol), as well as other metabolic abnormalities. The underlying pathophysiology seems to be largely, but not uniquely, attributable to insulin resistance. Existing antihypertensive drugs were designed to lower blood pressure rather than to modify the metabolic abnormalities associated with hypertension. This review considers the role of renin-angiotensin system inhibition and especially the use of angiotensin receptor blockers (ARBs) in the treatment of hypertension in MetS. There are differences among ARBs. Among them is the uricosuric effect of losartan. Furthermore, telmisartan may function as a partial agonist of the peroxisome proliferator-activated receptor-gamma (PPAR-gamma).
机译:代谢综合征(MetS)是心血管疾病和死亡率以及新型2型糖尿病的有力预测指标。 MetS包括内脏肥胖,血压升高,葡萄糖代谢受损,动脉粥样硬化性血脂异常(甘油三酯升高和高密度脂蛋白胆固醇水平低)以及其他代谢异常。潜在的病理生理学似乎在很大程度上而非唯一地归因于胰岛素抵抗。现有的降压药旨在降低血压,而不是改变与高血压相关的代谢异常。这篇综述考虑了肾素-血管紧张素系统抑制的作用,尤其是血管紧张素受体阻滞剂(ARBs)在治疗大都会高血压中的作用。 ARB之间存在差异。其中有氯沙坦的尿酸排泄作用。此外,替米沙坦可能充当过氧化物酶体增殖物激活受体-γ(PPAR-γ)的部分激动剂。

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