From Artana is a group of medicines of antihimensifying action in its nature similar to ACE inhibitors, but working in a fundamentally different way.

The question of the appropriateness of the application of one or another name, the group is solved by a cardiologist. Often, a specialist selects a course of therapy by the method of sample, starting with small doses and tracking the results and response of the body to the introduction of a medication.

Sartans should not be accepted independently, without indications and destination. These are serious funds, questions completely in the competence of doctors.

The basis of the work of the Medications of the group under consideration lies blocking a certain component of the organism's natural physiological activity. To begin with, it is worth saying a few words about how arterial pressure is increasing.

For the tone of the vessels, its regulation and, accordingly, the indicators of blood pressure, the whole group of specific substances of the human body is responsible: cortisol, adrenal cortex hormones, aldosterone and angiotensin-2.

The latter has the most pronounced action. When the vessels are affected on the vessels of this compound, the walls come into elevated tone. There is their narrowing and a change in the enlightenment of the body's arteries. Ultimately, the pressure is growing, the jumps of the indicator begin.

Sartans are blockers angiotensin receptors, that is, special fibers, which are located in vascular structures and are responsible for the perception of signals. Those who are stimulated as a result of the influence of the substance when it is developed.

The key difference between the mechanism of action of sartans from similar inhibitors of ACE is to block the final phase of the reaction - the body simply does not perceive the signals from the effect of angiotensin on the vessels, the spasm does not happen, the pressure remains normal.

As for the ACE inhibitors, they reduce the synthesis rate itself, the concentration of it becomes less, which leads to normalization arterial pressure.

To say unequivocally, what medications are better, it is impossible. Depends on the situation, the tolerance of drugs, a number of other factors of a subjective nature.

Indications for use

Indications for the use of angiotensin-2 receptor blockers (abbreviated Branch) are obvious, are determined by cardiological changes from the body.

Among specific reasons for use:

Arterial hypertension

As a rule, Sartans are prescribed, starting from and later. These are rather severe drugs, it has a pronounced effect, therefore do not apply in patients at the initial phase of the pathological process. Since it is possible to be too serious a decrease in the indicator of blood pressure. It is no less dangerous.

The question of expediency needs to be addressed on the basis of these objective diagnostics.

Replacement therapy with the impossibility of using the IAPF

Despite the fact that these funds have a similar end result, they have a fundamentally different chemical structure.

A similar effect based on an inadential structure can be used for benefit. For example, when the patient is due to the peculiarities of immunity, type preparations are not able to transfer.

Other important moment It concerns the ineffectiveness of this group of medicines. In the case of the resistance of the pathological process, it makes sense to appoint close to the global drug classification. Sartans are just fit for complex therapy.

Medicines of this species are suitable for correction both primary and secondary ,.

In the latter case, it is necessary to eliminate the root cause of deviation.

Chronic heart failure

Disorders of this plan have ischemic origins. Myocardia is missing nutrients and oxygen.

The result is a rapid increase as a result of partial cell death. This is not a heart attack, but not far until the moment of critical state.

Sartans in the system with other medicines reduce the likelihood of a negative phenomenon. Although no one does not give one hundred percent warranty, it is necessary to systematically be checked under the control of the cardiologist. In order not to miss the moment of decompensation, adjust the course of therapy.

Next to the defeat of target organs

First of all, the retina eye. As a result of a long flow arterial hypertension There are foci of dystrophy. Nutritional blood, nutrients, mesh eye shell starts to drop. Possible breaks and disorders by the type of detachment.

This is not a comic condition. Probably complete disappearance of the ability to see.

Sartans have the function of the protector, that is, the means protecting cells from destruction.

The retina of the eye, even under the influence of short-term periods of insufficient nutrition and respiration, does not change. Inhibitors of ACE also possess the same effect.

Increased survival of patients with suffered infarction

Angiotensin II receptor blockers accelerate and stabilize nutrition and cell gas exchange. Because the chances of correction and recovery in patients are much more than those who do not receive such therapy.

Sartans are not a panacea. Therefore, they need to be used with caution, under the control of the specialist. All non-standard sensations should be immediately reported to his doctor.

Classification for the acting substance

The drug division is carried out according to the main active substance constituting the foundation of the therapeutic effect of the drug.

Accordingly, four types of drugs can be called.

Tetrazole derivatives

• Candesartan. The result is manifested in 1-2 hours. It is preserved for about 12 hours. At the same time, the medication has the ability to accumulate in the body. Due to the systematic use, a better therapeutic effect is possible.

List of titles: Angicand, Ataanda, Hyposart, Candaker, Xarten, Ordissa.

• Lozartan. The result comes quickly, a few hours later. Duration is preserved for almost a day. Depending on the dosage used. It makes sense to take a medication only if everything is in order with the liver. It is metabolized by this way, because any violations on the one hand will become more pronounced, and on the other, the useful result from the use of sartans will decrease.

Losartan on the shelves of pharmacies is represented by a group of trade names: Blocktatra, Vasotenz, Zisakar, Karzarttan, Lozell, Lorist, Renyikard. They are completely similar, the difference only in the manufacturer.

Neverocyclic means

The main name of this group is Valsartan. As in the previous case, it refers to the "root", others are considered to be its counterparts.

Used to urgently relieve blood pressure. It can also be used for constant correction of diseases of the cardiovascular system. According to some studies, almost half increases the survival rate of patients with myocardial infarction.

The pharmacological effect occurs after 1-2 hours from the moment of reception. The means is displayed quickly, so the dosing mode must be appropriate.

List of trade names:Vals, Valsafors, Waltacor, Diva, Nortivan, Tareg.

Nebiffonyl preparations

Eprosartan (Teveten). With any outstanding properties do not possess. It is used primarily to correct the disorders of the heart, increasing the survival of patients after the suffered infarction.

The list of sartan preparations is wider, only the main names are named.
The fourth representative is found in the realities of Russian medicine somewhat less often. At the moment you can meet extremely few items. it modern drugs (see below).

Classification for generations

Another classification method is based on generations of medicines.

There are two of them two.

• The first is all the above preparations. Block only one group of receptors. The therapeutic effect at the same time significant, they are not outdated yet. In the context of Russian clinical practice Used most actively.
• Second generation. Presented poorly but it has a comprehensive action. It can stabilize the state quickly and has a minimum of side effects. Doctors prefer to apply this class.

It is undesirable to use within the framework of monotherapy, without supporting medication of auxiliary groups.

Preparations of the last generation

So-called nebiffenyl Tetrazole derivatives. The latter generation sartans are represented by only one tool in the Russian market - Teleminsartan, he is also Macardis.

The drug has many advantages:

• Bioavailability. Through what the drug has a higher therapeutic potential and the ability to normalize the state of the person.
• Disagreement through the digestive tract. For this reason, it is possible to use in patients with renal failure. The last generation of sartans in this regard is safer.
• The minimum deadlines for useful action. About 30 minutes. The result holds about the day.
• No need to often take a tool. 1 per day.

In addition, there is much less side phenomena.

What is better: sartans or ACF inhibitors?

The question is complex. As noted earlier, talking about the principal, conceptual advantage of a group is not true.

It is necessary to repel from a particular clinical situation, the age of the patient, its gender, the general state of health, the individual reaction to treatment.

The key differences between the sartans and the ACE inhibitors is, on which section of the chain of the negative phenomenon is interrupted:

• In the case of sartans, angiotensin is produced as usual. But the vessels due to the effect of the drug are insensitive to this compound. The effect is minimal, the arteries remain in the state of the same tone.
• When taking the IAPF - there is a decrease in the amount of substance.

In general, both groups of drugs can be considered as identical to the effectiveness and therapeutic potential of funds.

They are interchangeable, can be used in the ineffectiveness of the opposite group. Thus, the question of what type it does not have any practical meaning.

Possible side effects

Negative phenomena in the selection of correct dosages are relatively rare. Medicine tolerance is pretty high, which allows without any problems to take their long period of time.

Among negative phenomena, the following can be distinguished:

• Cough. Unproductive, without wetting. Considered the result of irritation of the epithelium respiratory tract. The nature of the state is not fulfilled.
• Dyspepsichi. Typical for the preparations of the cardiology profile. Among the likely phenomena there are pains in the abdomen, nausea, vomiting. Stool disorders by type of constipation, diarrhea and their alternations for several days.

There is a bitter in the mouth, increased intestinal gas formation. In the presence of diseases of the digestive tract, the likelihood of side effects is growing. It is necessary to observe well-minded, so as not to miss the disorder.

• Allergic reactions. There are often among other negative phenomena. The most common violations of this plan in patients: urticaria, the occurrence of skin rash, the swelling of the dermal layers, redness without itching. Anaphylactic shock, swelling of quinque, extremely rarely. It is rather an exception.
• Muscle pain. Malgia. The origin is not fully understood.
• Disorders of kidney functions. Dysuric phenomena. Reducing the frequency of urges to visit the toilet, it is possible to drop the amount of daily urine.
• Dizziness. Violation of orientation in space. Comparatively low intensity. A person can move independently.
• Weakness, drowsiness, apathetic. Manifestations of asthenic syndrome. In the framework of labor or training activities, it is possible to reduce productivity.
• There are changes in laboratory tests. This must be taken into account when interpreting the results of diagnostics.

In patients with suffered infarction, additional negative consequences of the reception of Sartan are observed:

• . Pressure drop with a sharp rush, body position change.
• Tachycardia. An increase in the number of heart abbreviations. Rarely. The means affect hell, and not on the heart rate.
• Headaches.
• Liver disorders.

Medicinal interaction

The pharmaceutical cross-effect of some medicines on other depends on the specific means. These are most often detected effects:

• With parallel reception with ACE inhibitors, a mutual gain of useful action is observed. Blood pressure is reduced faster and in broader limits. Therefore, such combinations can only be used in patients with pronounced violations of the cardiovascular system.
• If the sartans are accepted together with (Veroshpiron, Spironolactone) is the likelihood of increasing the concentration of mineral salts, electrolytes. This is fraught with a violation of the heart. Therefore, it is necessary to conduct a strict observation of the patient's condition.
• The systemic use of medicines of the group under consideration and non-steroidal anti-inflammatory agents is categorically not recommended due to the weakening of the opposite effect.
• Finally, when using sartans and other means to combat high blood pressure, the action is enhanced.

Medicinal interaction makes it possible to understand how the body reacts to one or another combination in advance.

Contraindications

The grounds for the failure of the application of sartans are not so much. For the most part, they are relative. That is, after elimination of the state, you can resort to use.

• Individual intolerance to the components of the drug. It is considered an absolute contraindication. Since not to avoid allergic reactions.
• Age up to 18 years. Research on children was not carried out. Because the use of medicines of the group under consideration is unacceptable. Unpredictable complications are possible.
• Violations of the liver function. Pronounced disorders of the gland. Including against the background of hepatitis, sub- and decompensated cirrhosis, other disorders.
• Pregnancy. Sartanes negatively affect the hemodynamics of the fetus and can lead to a disruption of its nutrition. Therefore, at any stage of gestation, medicines of this type are contraindicated.
• Lactation. Breast-feeding. The components of the drug penetrate the milk and are transmitted to the child. Application during this period is unacceptable.
• Also violations of the kidney function. In decompensated phase. In order not to provoke even greater state exacerbation.

Contraindications need to be adhere to strictly, so as not to cause negative unpredictable consequences of thoughtless drugs.

Sartans are used for therapy of arterial hypertension. These are funds individual choice. The question of the need and the overall use of the application is completely under the jurisdiction of a cardiologist.

Sartans, angiotensin II receptor antagonists: what it is how drugs work, a list of the best representatives, contraindications

Sartan is a class of hypotensive drugs that reduce the sensitivity of the vessel wall receptors, hearts to hormone angiotensule 2, which stimulates their reduction. This is one of the youngest drug groups lowering pressure. It was created as an AAPF alternative, whose reception is often accompanied by a complication - dry cough.

Consider the mechanism of action of the Sartan, the classification of the sconce, the main indications, contraindications, adverse reactions, features of drug interactions.

pharmachologic effect

One of the main systems regulating blood pressure (AD), the total volume of circulating blood is called Renin-angiotensin-aldosterone (RAAS). This is a complex chain of reactions, interactions of liver hormones, kidneys, adrenal glands, which adjusts the tone of the vascular wall, the amount of water released. Under the influence of angiotensin-2, the arteries are reduced, which leads to a narrowing of their lumen, an increase in blood pressure.

Sartans for arterial hypertension (AG) help cells to resist the action of hormone. They block the sensitive angiotensin-2 receptors and the myocytes of vessels begin to ignore its presence.

In addition to hypotensive influence, the sconium has a number of ad-independent effects, this explains the need to use drugs for the treatment of heart diseases, kidneys.

Organoprotective, exchange properties of a group of sartan (5)

• reducing the load on myocardium;
• braking, elimination of left ventricular hypertrophy;
• preventing the development of atrial fibrillation;
• improving the work of the heart in chronic organ failure.

• reduction of the probability of stroke;
• improving cognitive functions in patients with arterial hypertension.

• reduction of edema;
• increasing potassium level;
• elimination of selection of protein with urine (proteinuria);
• slowing down the progression of renal failure.

• an increase in sensitive tissues to insulin;
• reducing blood sugar levels;
• dehibition of atherosclerosis development;
• reducing the risk of sugar diabetes in patients aging;
• reducing the concentration of triglycerides, total cholesterol, LDL, increasing the content of HDL.

Classification of drugs

A group of Sartan is represented by 4 subgroups, various chemical buildings.

List of recent generation sartans, drug titles

There are two generations of sconce. Representatives of the first is Valsartan, Kandesartan, Lozartan, Olmertan, Eprosartan, Irbesartan. All of them block only one type of receptors (AT-1). Sartans of the second generation have two mechanisms of action: inhibit angiotensin receptors, in-type peroxisis proliferation activator (PPAR-Y). The latter adjusts:

• cell differentiation;
• exchange of lipids, carbohydrates;
• sensitivity of adipose tissue to insulin;
• oxidation of fatty acids.

The only representative of the second generation of the head, registered in Russia, is Telmisartan (Macardis). In addition to typical properties, it is much more efficient:

• prevents the development of atherosclerosis;
• reduces the plasma concentration of triglycerides, glucose;
• normalizes the hormonal activity of the pancreas;
• improves metabolic indicators in patients diabetes;
• has an anti-inflammatory effect;
• smoothes some negative reactions from tiazide diuretics.

However, the power of the influence on the blood pressure of the sardana varies with each other. The maximum difference in systolic indicators, diastolic blood pressure is 2 mm Hg. Art. This explains the widespread use of first-generation drugs, including losartan, which was synthesized first.

List of most effective first generation sartans

• Voz;
• Valsafors;
• Waltacor;
• Doda;
• Nortivan;
• Tareg.

• Blocktrans;
• Vasotenz;
• ZISAKAR;
• Karzarttan;
• LOOP;
• Lorist;
• Renikard.

• Approvnel;
• Ibertan;
• Firma.

• Angicand;
• Ataanda;
• Hyposart;
• Candaker;
• Xarten;
• Ordissa.

Indication for appointment

Most often, the sardans are prescribed as a hypotensive agent with patients with arterial hypertension. The combination of the head with other drugs is also effective when:

• chronic heart failure;
• nephropathy;
• microalbuminuria;
• thickening the wall of the left ventricle;
• diabetes;
• metabolic syndrome;
• atherosclerosis;
• atrial fibrillation;
• myocardial infarction (Valsartan only).

Application of sartans in arterial hypertension

Wood belongs to the hypotensive means of the first line: they are recommended to assign earlier other tablets to reduce pressure. First priority candidates - patients who have arterial hypertension accompanied:

• hypertrophy of the left ventricle or impaired its work;
• chronic heart failure;
• excretion of albumin with urine (albuminuria);
• diabetes;
• concealment of the kidney (creatinine clearance less than 60 ml / min);
• post-infarction cardiosclerosis;
• chronic renal failure (with intolerance of ACE inhibitors);
• as an alternative to the IAPF, if a cough is developing against the background of their reception.

All sardans can be prescribed a separate course, combine with other hypotensive means. Monotherapy is less effective (56-70% of success) than comprehensive treatment (80-85% of success). The result from receiving the drug cannot be appreciated immediately. Performance peak accounts for 4-8 week of therapy.

Myocardial infarction

The only drug of the Sartan group, which is recommended by patients after the myocardial infarction - Valsartan. It is reliably known that it reduces mortality from a heart attack by 25%. The drug feature is high specificity to AT1 receptors, exceeding a similar losartan rate of 20 times (3).

The main advantages of the group

The main advantages of Sartan:

• minimum of contraindications;
• slowly removed from the body: just take 1 time / day;
• very low likelihood of side effects;
• suitable diabetics, elderly people, patients with kidney disease;
• do not cause cough;
• increase the life expectancy of patients with cardiovascular diseases;
• reduce the risk of stroke;
• unlike IAPF, the risk of lung cancer does not increase.

Potential side effects

The probability of the development of negative reactions after receiving Sartan is very small. According to some studies, it is comparable with this placebo. The most frequent complication - dizziness is associated with a decrease in pressure. To reduce discomfort, doctors recommend taking tablets for the night.

Contraindications

• with hypersensitivity to the components of the drug or the active substance;
• during pregnancy, lactation.

Because of the proven negative impact on the fruit of the fruit, the sconce is not recommended to take to women of childbearing age, which are unreliable protected. When revealing unplanned conception, the reception is stopped.

Also, sartans are prescribed with caution:

• children;
• patients with a decrease in total circulating blood;
• bilateral stenosis of renal arteries or narrowing the artery of the only kidney;
• expressed renal failure (creatinine clearance less than 10 ml / min);
• cirrhosis of the liver;
• obstruction of the biliary tract;
• simultaneously with drugs delaying potassium.

Possible drug interactions

All sardans are well compatible with other types of drugs. They can be taken together with all known drugs for the treatment of cardiovascular diseases, diabetes mellitus. They enhance the hypotensive effect of other types of drugs lowering the pressure, which must be considered by selecting the dose.

Additional control of blood laboratory indicators with the combined application of sartans and the following drugs are needed:

Are sartan cancer?

In 2010, the results of a large-scale analysis of several clinical studies were published. His authors revealed the pattern between the displacement of the score and the risk of cancer development. To verify the findings of scientists, American Food Control Office, as well as several independent researchers, conducted their own analysis, which did not reveal the relationship between the use of sartans, increasing the likelihood of cancer tumors. On the contrary, the application of the sconium has reduced the chances of the appearance of rectake neoplasms.

The issue of having the relationship of angiotensin and oncology receptor inhibitors is still not closed. However, one should not be afraid of hypotensive drugs. Even if the theory is not confirmed in their favor, this risk is extremely small, and the benefits are noticeable. To prevent cancer development, it will be much more efficient to fight with other risk factors, and not to give up the reception of drugs extending life.

Sartans or ACE inhibitors: What is better?

Inhibitors of an angiotensin-shift enzyme (IAPF) according to the mechanism of action are very similar to the angiotensin receptor blockers 2. They block the reaction of the conversion of angiotensin І in angiotensin ІІ.

Later it turned out that this path of education of the hormone is not the only possible. According to preliminary assessment, the use of Sartan should have solved this problem. After all, they inactivate the sensitivity of angiotensin receptors of any origin. This would enhance the hypotensive effect. However, in practice, this assumption was not justified: in the body there was another type of receptors that are not affected by the brain.

Both groups of drugs reduce the pressure approximately equally. The appointment of receptor blockers instead of the IAPP makes sense, primarily patients who, against the back of the latter, the dry cough is developing - exhausting, common side effect. In other cases, they are the preparations of choice.

In addition to hypotensive action, IAPF, Sartanes have a number of additional properties that positively affect the dynamics of the diseases of the cardiovascular system associated with it violations. However, the result of the operation of inhibitors is better studied, although in some diseases the purpose of angiotensin receptor blockers is more justified.

Sartans and the risk of myocardial infarction

In the 2000s, several studies were published, which demonstrated the relationship between the displacement of the sconce and a minor increase in the risk of a heart attack. The more detailed study of this issue did not confirm, did not refute their conclusions, since the results were contradictory.

However, even the most ardent skeptics are forced to admit: with the most pessimistic forecasts, this risk is very small. Much more dangerous incontrolled elevated blood pressure, unhealthy lifestyle, nutrition, smoking.

Sartans with arterial hypertension - a list of drugs, classification for generations and a mechanism of action

A deep study of the pathological states of the cardiovascular system made it possible to create receptor blockers to provoke high pressure Angiotensin II, known to patients as sardans in arterial hypertension. The main purpose of such drugs is the correction of blood pressure, each jump of which brings the offensive of serious problems with the heart, kidneys and brain vessels.

What is sartans in arterial hypertension

Sartans belong to the group of inexpensive drugs that reduce blood pressure. In persons predisposed to hypertension, these medicines become an integral component of stable vital activity, significantly improving longevity prospects. In the composition of drugs there are components that have a corrective impact on pressure throughout the day, they prevent the offensive of hypertensive attacks and carry out the prevention of the disease.

Indication for appointment

The main indication for the use of sartans is hypertensive disease. Especially they are shown to persons who sharpen the therapy with beta blockers, because they do not affect the metabolic processes in the body. Patients with heart failure of sartans are prescribed as a drug that slows the work of the mechanisms leading to the dysfunction of myocardium and left ventricle. In neuropathy, they protect the kidneys and counteract the loss of the protein body.

In addition to the main indications for use, there are additional factors confirming the benefit of Sartan. These include the following effects:

• ability to reduce cholesterol;
• reducing the risks of Alzheimer's disease;
• strengthening the wall of the aorta, which serves as an additional protection against the effects of hypertension.

Mechanism of action

With oxygen fasting and decrease in blood pressure, a special substance is beginning to form in the kidney, which transforms angiotensinogen to angiotensin I. Next angiotensin I, under the influence of special enzymes, angiotensin II is converted, which, enclosing the receptors sensitive to this connection, causes hypertension. Preparations affect these receptors, not allowing hypertensive trends.

Advantages of drugs

Due to high efficiency In the treatment of hypertensive crises, Sartans have occupied an independent niche and are considered as an alternative to the IAPF (inhibitors of an angiotensin glider enzyme), previously prevailed in the practice of preventing and treating different stages of hypertension. The proven benefits of drugs include:

• improving symptoms in patients with cardiac metabolic failure;
• reducing the risk of stroke, atherosclerosis;
• reducing the likelihood of atrial fibrillation attack;
• efficient and continuous blocking of the actions of angiotensin II;
• lack of accumulation in the Bradikinin body (which provokes a dry cough);
• good tolerance of elderly persons;
• no negative impact on sexual functions.

Classification

Trade names of Sartan a lot. By chemical composition and, as a result, influence on the human body, drugs are divided into four groups:

• Bifenyl derivatives Tetrazole: Losartan, Irbesartan, Kandesartan.
• Nebiffenyl derivatives Tetrazole: Telmisartan.
• Nebiffenyl Nettrazoles: Eprosartan.
• Non-cyclic compounds: Valsartan.

List of drugs

The use of Sartan has found wide demand in medicine practicing various methods Therapy with an increase in blood pressure. The list of well-known and used funds in secondary hypertension includes:

• Lozartan: Renikard, Lotter, Prezartan, Lorist, Losakor, Losarel, Kozar, Lozap.
• Valsartan: Tareg, Northwan, Tantordio, Valsakor, Diva.
• Eprosartan: Tevevent.
• Irbesartan: Company, IberTan, Approvnel, Irsar.
• Teleminsartan: Primetor, Macardis.
• Olmertan: Olimestra, Cardosal.
• Kandesartan: Ordiss, Kandesar, Hyposart.
• Azilsartan: Earbie.

Sartan last generation

By the first generation, those drugs that have an action exclusively on the hormonal system that is responsible for blood pressure (RAAS) through blocking of sensitive AT 1 receptors is rated. Sartans of the second generation Bifunctional: they suppress undesirable manifestations of RAAS and have a positive effect on pathogenetic algorithms of violation of the exchange processes of lipids, carbohydrates, as well as inflammation (non-infectious) and obesity. Specialists confidently argue that the future of Sartan antagonists in the second generation.

Instructions for use

Angiotensin receptor blockers appeared on the market relatively recently. Take them should be appointed by the doctor in the dosage, depending on the individual characteristics of the patient. Preparations are used once a day, operate for 24-48 hours. The persistent effect of sartans is manifested after 4-6 weeks from the moment of treatment. Medicines remove the spasms of the vascular wall in renal symptomatic hypertension, can be prescribed as part of complex therapy in resistant hypertension.

Telmisartan.

A popular drug that is included in the group of angiotensin receptor blockers is televisartan. Indications for the use of this antagonist are the prevention of cardiovascular diseases and treatment of essential hypertension, it reduces cardiocyte hypertrophy, reduces the level of triglycerides. Tablets are accepted inside, regardless of food intake, in elderly patients and liver failure, the dose correction is not carried out.

The recommended dosage is 40 mg per day, sometimes it can decrease to 20 mg (renal failure) or increase to 80 (if systolic pressure does not fall persistently). Telmisartan is well combined with thiazide diuretics. The course of treatment lasts about 4-8 weeks. At the beginning of therapy, blood pressure should be monitored.

Features of the treatment of hypertension (hypertension) by Sartan

Sartans are customary to call special means, the action of which is directed to the receptor blockers to angiotensin II. Often the doctors prescribe them to patients suffering from hypertension, since using medication data it is possible to improve the state of pathology.

Principle of impact

During the process of reducing pressure in the kidneys, the deficiency of oxygen is formed, as a result of which Renin is produced. It is with its help that an angiotensin I appears, which is converted to angiotensin II. This substance is considered to be active componentwhich has an impact on pressure, increasing it. Therefore, the reception of sartans in the presence of patients with arterial hypertension helps to influence receptors, which prevents from hypertension.

Benefits

It is believed that the most effective medicines from hypertension are sardans, they differ next to the advantages:

• the dependence on long-term reception does not appear;
• with normal pressure indicators medications do not reduce it;
• well tolerated and have a minimum of negative consequences.

Also, the preparations improve renal functioning in diabetic nephropathy, guarantee the regression of the hearty hypertrophy and lead in terms of heart failure to normal.

To achieve maximum efficiency, scientists are recommended simultaneously with angiotensin II use diuretics. For example, "Indapamide" and "dichlotiazide". Experts note if adhere to this rule, it is possible to increase performance by 1.5 times. Thanks to thiazide diuretics, not only the effect of the effect occurs, but also the work of drugs is extended.

Indapamide

Additional impact of medication data:

1. Protection of cells is ensured nervous system. The medicine minimizes the adverse effect of the disease on the brain, being preventive tool from stroke. Since they affect the brain, often doctors prescribe their patients who are observed normal indicators Pressure, but there is a risk of vascular lesion.
2. The threat of paroxism of atrial fibrillation is reduced, which is ensured by the help of antiarrhythmic effects.
3. The risk of diabetes is reduced. For this, the metabolic effect corresponds to this, and in the presence of this disease, the patient's condition will be coming back, as the insulin resistance of the tissues is carried out.

Important! Such substances during hypertension normalize lipid metabolism, reduce cholesterol content, as well as triglycerides, uric acid volume. All this is very important when receiving diuretics.

Some sartans are beneficial for marfan syndrome, they strengthen the vessels and have prevention of their possible rupture. Also normalizes muscle state. Such an impact has "Lozartan".

Lozartan

Medical experts appoint Sartan to people who have such problems:

1. Hypertension, which is the main indicator for their use.
2. Heart failure, which can develop against the backdrop of the superchactive renin-angiotensin-aldosterone system. On the early stage Allows you to normalize the heart function.
3. Nephropathy is a dangerous consequence of diabetes, arterial hypertension. For the disease there is a decrease in the number of proteins allocated with urine. Medicines contribute to the slowdown in the development of renal failure.

Such drugs do not affect the metabolism, the permeability of the bronchi, the organs of vision. In rare cases, it can cause a dry cough, an increase in potassium level. The effect of the use of medicines will be visible in a month.

Features

Independent treatment with sartans is prohibited, the therapy scheme must be selected individually for each patient. Before appointment of drugs, special diagnosis is carried out, and the patient's condition features are being studied.

Important! Preparations need to be used every day, without a break.

Often the doctors discharge a combination of funds from Sartan and Diuretics. The most famous preparations for the treatment of hypertension are:

"Mykardis", its composition contains hydrochlorostiazide, as well as telemisartan;

Macardis
"Tevevent" has hydrochlorostiazide and eprosartan as the basis;

Teveven

These substances are also responsible for the protection of internal organs, they are safe, since they do not have side effects.

Classification of drugs

The cost of drugs depends on the manufacturer company, the duration of action. Using the cheapest drugs, the patient must understand that they are required to drink more often, as they differ in short exposure.

Preparations are divided according to the composition and exposure. Doctors divide them on prodrugs and active substances, based on the availability of active metabolite. By chemical composition, Sartans are:

• bifenyl derivatives of Tetrazole - "Lozartan", "Kandesartan" and "Irbesartan";
• non-cyclic - "Valsartan";

Valsartan.

Update Article 30.01.2019

Arterial hypertension (AG) In the Russian Federation (RF) remains one of the most significant medical and social problems. This is due to the widespread dissemination of this disease (about 40% of the adult population of the Russian Federation has an increased level of blood pressure), as well as the fact that the AH is the most important risk factor of the main cardiovascular diseases - myocardial infarction and brain stroke.

Permanent persistent increase in blood pressure (blood pressure) up to 140/90 mm. RT. Art. and higher - sign of arterial hypertension ( hypertensive disease).

The risk factors contributing to the manifestation of arterial hypertension include:

• Age (men older than 55 years old, women over 65)
• Smoking
• sedentary lifestyle,
• Obesity (waist amount of more than 94 cm for men and more than 80 cm for women)
• Family cases of early cardiovascular diseases (men under 55 years old, women under the age of 65)
• The magnitude of the pulse arterial pressure in the elderly (the difference between systolic (upper) and diastolic (lower) arterial pressure). Normally, it is 30-50 mm RT Art.
• Plasma glucose an empty stomach 5.6-6.9 mmol / l
• Dyslipidemia: total cholesterol more than 5.0 mmol / l, low-density lipoprotein cholesterol 3.0 mmol / l and more, high density lipoprotein cholesterol 1.0 mmol / l and less for men, and 1.2 mmol / l and less for Women, triglycerides more than 1.7 mmol / l
• Stressful situations
• alcohol abuse
• Excessive salt use (more than 5 grams per day).

Also, the development of AG contributes to diseases and conditions as:

• Sugar diabetes (glucose in plasma on an empty stomach 7.0 mmol / l and more during repeated measurements, as well as glucose in blood plasma after eating 11.0 mmol / l and more)
• Other Endocrinological Diseases (Feochromocytoma, Primary Aldosteronism)
• Diseases of the kidneys and renal arteries
• Reception of drugs and substances (glucocorticosteroids, non-steroidal anti-inflammatory drugs, hormonal contraceptives, erythropoietin, cocaine, cyclosporine).

Knowing the causes of the disease, you can prevent the development of complications. In the risk group are the elderly.

According to the modern classification adopted by the World Health Organization (WHO), AG is divided into:

• 1 degree: Increased blood pressure 140-159 / 90-99 mm RTCT
• 2 degree: Increased blood pressure 160-179 / 100-109 mm RTC
• 3 degree: Increased blood pressure up to 180/110 mm RTTC and higher.

The blood pressure indicators obtained at home can become a valuable addition when monitoring the effectiveness of treatment and are important when the AG is detected. The task of the patient is to conduct the blood pressure self-control diary, where the indicators of the blood pressure and pulse are recorded when measuring, at least in the morning, at lunch, in the evening. It is possible to comment on the lifestyle (lifting, eating, physical activity, stressful situations).

Technique measuring hell:

• Quickly pump air into the cuff to the pressure level, by 20 mm RTTC, exceeding systolic blood pressure (garden), on the disappearance of the pulse
• Hell is measured with an accuracy of up to 2 mm RTCT
• Reduce the pressure in the cuff at a speed of about 2 mm RTTC in 1 second
• The pressure level in which the 1st tone appears, the garden corresponds to
• The pressure level at which the disappearance of the tones corresponds to the diastolic arterial pressure (DDA)
• If the tones are very weak, you should raise your hand and perform several compressive movements with a brush, then the measurement is repeated, and it should not be very comprehended by the artery of the membrane of the Phondoscope
• In the primary measurement, the hell is fixed on both hands. In the future, the measurement is carried out on the hand on which hell is higher
• In patients with diabetes and in persons receiving antihypertensive agents, the hell should also be measured after 2 minutes of stay in the standing position.

Patients with ag are pain in the head (often in the temporal, occipital region), episodes of dizziness, rapid fatigue, poor sleep, may occur pain in the heart, violation of vision.
It is complicated by hypertensive crises (when hell is sharply rising to high digits, rapid urination occurs, headache, dizziness, heartbeat, heat feeling); impaired kidney function - nephrosclerosis; strokes, intracerebral hemorrhage; Myocardial infarction.

For the prevention of complications of patients with AG, it is necessary to constantly monitor its blood pressure and take special antihypertensive drugs.
If a person is worried about the above complaints, as well as pressure 1-2 times a month - this is a reason to refer to the therapist or cardiologist, which will appoint the necessary surveys, and subsequently determine the further tactics of treatment. Only after the necessary survey complex it is possible to talk about the appointment of drug therapy.

An independent purpose of drugs may threaten the development of undesirable side effects, complications and may have a fatal outcome! It is prohibited to the independent use of medicines according to the principle "helped familiar" or resort to the recommendations of pharmacists in pharmacy chains !!! The use of antihypertensive drugs is possible only by appointment of a doctor!

The main purpose of the treatment of patients with AG consists in maximizing the risk of developing cardiovascular complications and death from them!

1. Activities for lifestyle change:

• To give up smoking
• Normalization of body weight
• Consumption of alcoholic beverages less than 30 g / day alcohol for men and 20 g / day for women
• Increased exercise - regular aerobic (dynamic) load of 30-40 minutes at least 4 times a week
• Reducing the consumption of the table salt up to 3-5 g / day
• Changing the power mode with an increase in plant food consumption, increasing in potassium diet, calcium (contained in vegetables, fruits, grain) and magnesium (contained in dairy products), as well as a decrease in animal consumption of fats.

These activities are prescribed to all patients with arterial hypertension, including those receiving antihypertensive drugs. They allow: reduce blood pressure, reduce the need for antihypertensive preparations, favorably affects the available risk factors.

2. Medical therapy

Today we will talk exactly about these drugs - modern means for the treatment of arterial hypertension.
Arterial hypertension is a chronic disease that requires not only constant control of blood pressure, but also a permanent reception of drugs. There is no course of antihypertensive therapy, all drugs are accepted indefinitely. With the inefficiency of monotherapy, the selection of drugs from various groups is carried out, often combining several drugs.
As a rule, the patient's desire with AG is the strongest, but not expensive drug. However, it is necessary to understand that this does not exist.
What drugs for this offer patients suffering from high pressure?

Everyone antihypertensive drug It has its own mechanism of action, i.e. affect those or other "Mechanisms" raising blood pressure :

a) renin angiotensin system - A substance is produced in the kidneys (with a decrease in pressure), which goes into the blood in Renin. The renin (proteolytic enzyme) interacts with the blood plasma protein - angiotensinogen, as a result, an inactive substance of angiotensin I is formed. Angiotensin when interacting with an angiothesin-plating enzyme (ACE) enters the active substance angiotensin II. This substance contributes to an increase in blood pressure, narrowing the vessels, an increase in the frequency and force of heart rate, the excitation of the sympathetic nervous system (which also leads to an increase in blood pressure), strengthening the production of aldosterone. Aldosterone promotes sodium and water delay, which also enhances hell. Angiotenzine II is one of the strongest vessels in the body.

b) Calcium Channels of our organism - Calcium in the body is in the associated state. When calciding is admitted through special channels into the cell, the formation of a contractile protein - actomyosis. Under his action, the vessels are narrowed, the heart begins to shrink more, the pressure rises and the heart rate increases.

c) adrenoreceptors - In our body in some organs there are receptors, the irritation of which affects blood pressure. Such receptors include alpha-adrenoreceptors (α1 and α2) and beta-adrenoreceptors (β1 and β2). The focusing of α1-adrenoreceptors leads to an increase in blood pressure, α2-adrenoreceptors to decrease the blood pressure .α-adrenoreceptors are arranged in the arteries. β1 adrenoreceptors are localized in the heart, in the kidneys, their stimulation leads to an increase in the heart rate, increasing the need of myocardium in oxygen and increase blood pressure. Stimulation of β2-adrenoreceptors located in bronchioles causes the expansion of bronchiol and removal of bronchospasm.

d) urinary system- As a result of an excessive amount of water in the body, hell rises.

e) central nervous system- The excitation of the central nervous system increases blood pressure. In the brain there are vascular centers governing the level of blood pressure.

So, we considered the basic mechanisms of improving blood pressure in the human body. It's time to move to the means to reduce pressure (antihypertensive) that affect these very mechanisms.

Classification of funds for arterial hypertension

1. Diuretics (diuretic)
2. Calcium channel blockers
3. Beta adrenoblocators
4. Means acting on a renin angiotensive system
   1. Blockers (antagonists) angiotensive receptors (sartans)
5. Neurotropic agents central action
6. Tools acting on the central nervous system (CNS)
7. Alpha adrenoblocators

1. Diolets (Diuretics)

As a result of the elimination of excessive fluid from the body, blood pressure is reduced. A diuretic tools prevent the reverse absorption of sodium ions, which are derived from the outside and carries out water. In addition to sodium ions, diuretics are flushed out of the body of potassium ions, which are necessary for the work of the cardiovascular system. There are diuretic products saving potassium.

Representatives:

• Hydrochlorothiazide (hypothiazide) - 25mg, 100mg, is part of the combined drugs; Long-term use in the dosage above 12.5 mg is not recommended, due to the possible development of type 2 diabetes mellitus!
• Indapamide (Arifonredard, Rowed Wed, Indapamide MV, Indap, Ionik Retard, Acrypamidredard) - more often Dosage 1,5mg.
• Triampur (combination diuretik, containing potassium-saving triamtener and hydrochlorostiazide);
• Spironolactone (Veroshpiron, Aldakton). It has a significant side effect (men causes the development of gynecomastia, median).
• Eplerenone (Inspra) - is often used in patients with chronic heart failure, it does not cause the development of gynecomastia and medodinia.
• Furosemide 20mg, 40mg. The preparation is short but quick action. It slows down the reabsorption of sodium ions in the rising knee of the loop of Genlen, proximal and distal tubules. Increases bicarbonate, phosphates, calcium, magnesium.
• Toramsemid (Diiouver) - 5mg, 10mg, is a loop diuretic. The main mechanism of the drug is due to the reversible binding of the thoracemide with the cable carrier of sodium / chlorine / chlorine ions / potassium, located in the apical membrane of the thick segment of the rising part of the loop of the loop of Genla, as a result of which the reabsorption of sodium ions is reduced or fully inhibited and the osmotic pressure of the intracellular fluid and the reabsorption of water decreases. Blocks aldosterone myocardial receptors, reduces fibrosis and improves myocardial diastolic function. Thoraraside to a lesser extent than furosemide causes hypocalemia, while it exhibits greater activity, and its action is longer.

Diuretics are prescribed in a complex with other antihypertensive drugs. The drug Indapamide is the only diuretic applied at AG on their own.
A diuretic rapid action (furosemide) is undesirable to apply systematically with hypertension, they are taken in case of emergency states.
When applying diuretics, it is important to take potassium preparations by courses up to 1 month.

2. Calcium channel blockers

Calcium channel blockers (calcium antagonists) is a heterogeneous group of drugs having the same mechanism of action, but differing in a number of properties, including according to pharmacokinetics, tissue selectivity, effect on the frequency of heart abbreviations.
Another name of this group is calcium ion antagonists.
There are three main subgroups of AK: dihydropyridine (the main representative - nifedipine), phenylalkylamin (the main representative - verapamil) and benzothiazepines (the main representative - Diltiazem).
Recently, they began to divide into two large groups, depending on the impact on the frequency of heart abbreviations. Diltiazene and Verapamil refer to the so-called "rejuvenating rhythm" calcium antagonists (NEDIGIDROPIRODINOVY). The other group (dihydropyridine) includes amlodipine, nifedipine and all other Dihydropyrididin derivatives, increasing or non-changing heart rate.
Calcium channel blockers are used in arterial hypertension, ischemic Disease Hearts (contraindicated with sharp forms!) and arrhythmias. At arrhythmias, not all calcium channel blockers are used, but only pulserizing.

Representatives:

Pulsusuring (NEDIGIDROPIRODINOVY):

• Verapamil 40mg, 80mg (prolonged: Isopin CP, Veroralide EP) - dosage 240mg;
• Diltiakeeze 90mg (altiazem pp) - dosage 180mg;

The following representatives (dihydropyridine derivatives) do not apply during arrhythmias: Contraindicated in acute myocardial infarction and unstable angina !!!

• Nifedipine (Adalat, Cordaflex, Cordafen, Cordypin, Corinthar, Nyfekard, Penigidine) - Dosage 10 mg, 20 mg; Nyfekardxl 30mg, 60mg.
• Amlodipine (Norvask, Normodipin, Tenox, Cordin Cord, Es Cordic, Cardopin, Kalkhek,
• Amlotop, Omeloarkardio, Amlovas) - Dosage 5mg, 10mg;
• Felodipine (Captionil, Felodip) - 2,5mg, 5mg, 10mg;
• Nimodipine (Nimotop) - 30mg;
• Lazidipin (Lazipil, Sakur) - 2mg, 4mg;
• Lercanidipine (Lercomen) - 20mg.

From the side effects of dihydropyridine derivatives, you can specify edema, mainly lower extremities Headache, Facial Redness, Pulse Beating, Urination Excience. If the edema is saved, it is necessary to replace the drug.
Lercamen, which is a representative of the third generation of calcium antagonists, due to higher selectivity for slow calcium channels, causes edema to a lesser extent compared to other representatives of this group.

3. beta adrenoblocators

There are funds, not selectively blocking receptors - non-selective action, they are contraindicated at bronchial asthma, chronic obstructive pulmonary disease (COPD). Other funds selectively block only the beta-receptors of the heart - selective action. All beta blockers prevent the synthesis of prophene in the kidneys, thereby blocking the renin-angiotensin system. In this regard, the vessels expand, hell decreases.

Representatives:

• Metoprolol (Betalk Zok 25mg, 50mg, 100mg, Egyot Retard 25mg, 50mg, 100mg, 200mg, Egyptions C, VaseCardinerell 200 mg, metabardard 100 mg) ;;
• Bisoprolol (Concorp, Coronal, Biol, Bisogamma, Cordinorm, Niperthen, Biprol, Bidop, Aritel) - Most often Dosage 5mg, 10mg;
• Nebivolol (non-binelol) - 5 mg, 10 mg;
• Betaxolol (Locase) - 20 mg;
• Carvedilol (Karvendrend, Coriol, Talliton, Dilatrend, Acrediol) - mostly dosage 6.25mg, 12,5mg, 25mg.

Preparations of this group are used in hypertension combined with ischemic heart disease and arrhythmias.
Short-breathing drugs whose use is not rational with hypertension: anaprilin (indisimated), atenolol, propranolol.

Basic contraindications to beta blockers:

• bronchial asthma;
• low pressure;
• sinus node weakness syndrome;
• pathologies of peripheral arteries;
• bradycardia;
• cardiogenic shock;
• atrioventricular blockade of the second or third degree.

4. Means acting on a renin angiotensin system

Preparations operate at different stages of the formation of angiotensin II. Some inhibit (suppress) an angiotensification enzyme, others block the receptors to which angiotensin II act. The third group inhibits renin, is represented by only one drug (alianis).

Angiotenzine Enzyme Enzyme Inhibitors (ACE)

These drugs prevent the transition of angiotensin I to active angiotensin II. As a result, the concentration of angiotensin II decreases in the blood, the vessels are expanding, the pressure is reduced.
Representatives (in brackets indicated synonyms - substances with the same chemical composition):

• Captive (Kopoten) - Dosage 25mg, 50mg;
• Enalapril (ReniPril, Berlipril, Renipril, Ednit, Anap, Enaren, Enam) - Dosage most often 5mg, 10mg, 20mg;
• Lysinopril (Dotroton, Dapril, Lizigamma, Leisioton) - Dosage most often 5mg, 10mg, 20mg;
• Perindopril (Preshaum A, Perines) - Perindopril - 2,5mg dosage, 5mg, 10mg. Perines - dosage 4mg, 8mg.;
• Ramipril (Tritacea, Amprilan, Kartil, Pyramil) - 2,5mg dosage, 5mg, 10mg;
• Hinapril (Akkiro) - 5mg, 10mg, 20mg, 40mg;
• Fozinopril (Fozicard, Monophil) - Dosage 10mg, 20mg;
• Transdolapril (gopten) - 2mg;
• Zofensoid (Zocardis) - Dosage 7,5mg, 30mg.

Preparations are available in different dosages for therapy with varying degrees of enhancement of blood pressure.

The peculiarity of the preparation of Captopril (Kopoten) is that he is due to its short-term action is rational only with hypertensive crises.

The bright representative of the Enalapril group and its synonyms are used very often. This drug does not differ in the duration of action, so take 2 times a day. In general, the full effect of APF Igraphs can be observed after 1-2 weeks of use of drugs. In pharmacies you can meet a variety of generics (analogs) of Enalapril, i.e. Cheaper, containing enalapril preparations that produce small manufacturers. We reasoned about the quality of generics in another article, it is worth noting that someone enalapril is suitable for someone, they do not work for someone.

ACE inhibitors cause a side effect - dry cough. In cases of cough development, the ACE inhibitors are replaced by the drugs of another group.
This group of drugs is contraindicated during pregnancy, has a teratogenic effect of the fetus!

Blockers (antagonists) angiotensin receptors (sartans)

These funds block angiotensin receptors. As a result, angiotensin II does not interact with them, the vessels are expanding, hell decreases

Representatives:

• Lozartan (Kozar 50mg, 100mg; Lozec 12.5mg, 50mg, 100mg; Lorist 12,5mg, 25mg, 50mg, 100mg; vasotenz 50mg, 100mg);
• Eprosartan (Teveten) - 400mg, 600mg;
• Walssartan (40mg, 80mg, 160mg, 320mg; Waltacor 80mg, 160mg, 320mg, Vals 40mg, 80mg, 160mg; Nortivan 40mg, 80mg, 160mg; valsafors 80mg, 160mg);
• Irbesartan (Approvnel) - 150mg, 300mg;
  Kandesartan (atacand) - 8mg, 16mg, 32mg;
  Telmisartan (Macardis) - 40mg, 80 mg;
  Olmertan (Cardosal) - 10mg, 20mg, 40mg.

Just as predecessors, allow us to estimate the full action after 1-2 weeks after the start of reception. Do not cause dry cough. Do not apply during pregnancy! When pregnaning pregnancy during the treatment period, hypotensive therapy with drugs of this group should be discontinued!

5. Neurotropic means of central action

Neurotropic drugs of central action affect the vessels center in the brain, reducing its tone.

• Moxonidine (Physiotense, Moksonitex, Moksogamma) - 0.2 mg, 0.4 mg;
• Rilmenidin (Albarel (1MG) - 1MG;
• Metyldop (operated) - 250 mg.

The first representative of this group is clofelin, which has been widely used earlier with AG. Now this drug is released strictly by recipe.
Currently, Moxonidine is used as for emergency With hypertensive crisis, and for planned therapy. Dosage 0.2 mg, 0.4 mg. Maximum daily dosage 0,6mg / day.

6. Means operating on the central nervous

If the AG is caused by prolonged stress, then drugs acting on the central nervous system are used (sedatives (novative, perrsen, valerian, dyeing, tranquilizers, sleeping pills).

7. Alpha Adrenoblocators

These funds are attached to alpha-adrenoreceptors and block them for irritant effects of norepinephrine. As a result, hell is reduced.
The used representative - doxazosin (Cardura, Tonokardin) - more often produced in dosages 1 mg, 2 mg. It is used to relieve attacks and long-term therapy. Many drugs of alpha blockers are removed from production.

Why are few drugs at once with arterial hypertension

IN initial stage The disease doctor prescribes one drug, on the basis of some studies and, taking into account the diseases of the patient. If one drug is ineffective, other drugs are often added, creating a combination of drugs to reduce blood pressure, affecting various mechanisms to reduce blood pressure. Combined therapy for refractory (sustainable) arterial hypertension can combine up to 5-6 drugs!

Preparations are selected from different groups. For example:

• aPF / diuretic inhibitor;
• angiotensin / diuretic receptor blocker;
• aFF inhibitor / calcium channel blocker;
• aCF / Calcium Channels / Beta-Adrenoblocator;
• an angiotensin receptor block / calcium channel blocker / beta-adrenoblocator;
• aFF inhibitor / calcium channel blocker / diuretic and other combinations.

There are combinations of drugs that are irrational, for example: beta blockers / calcium channel blockers pulserizing, beta blockers / central action preparations and other combinations. It is dangerous to engage in self-medication !!!

There are combined drugs combining in 1 tablet components of substances from different groups of antihypertensive drugs.

For example:

• aCF / diuretic inhibitor
  • Enalapril / Hydrochlorothiazide (Ko-Renatez, ENAP NL, ENAP N,
  • ENAP NL 20, Renipril GT)
  • Enalapril / Indapamide (Enzyx Duo, Enzyme Duo Forte)
  • Lysinopril / Hydrochlorothiazide (Iruzide, Leisioton, Lithan H)
  • Perindopril / Indapamide (Noliprelai Nolipreforte)
  • Hinapril / hydrochlorothiazide (accumulated)
  • Fozinopil / Hydrochlorothiazide (Fozicard H)
• angiotensin receptor blocker / diuretic
  • Lozartan / Hydrochlorothiazide (Gizar, Lozap Plus, Lorista N,
  • Lorist ND)
  • Eprosartan / Hydrochlorothiazide (Teveten Plus)
  • Valsartan / Hydrochlorothiazide (co-doda)
  • Irbesartan / Hydrochlorothiazide (Co-Approvnel)
  • Candesartan / Hydrochlorothiazide (Ataanda Plus)
  • Telmisartan / HCHT (McCardis Plus)
• aCF / Calcium Channel Ingiber
  • Transdolapril / Verapamil (Tarka)
  • Lysinopril / Amlodipine (Equator)
• angiotensin receptor blocker / calcium channel blocker
  • Valsartan / Amlodipine (Exeffer)
• dihydropyridine calcium channel blocker / beta blocker
  • Felodipine / metoprolol (logism)
• beta blocker / diuretic (it is impossible in diabetes and obesity)
  • Bisoprolol / hydrochlorothiazide (Lodoz, Aritel Plus)

All drugs are produced in different dosages of one and another component, the dose must be selected for the patient.

The achievement and maintenance of target levels of blood pressure require long-term medical observation with regular control of the patient's implementation of recommendations on how to modify the lifestyle and compliance with the admission mode of appointed antihypertensive agents, as well as correction of therapy, depending on the effectiveness, safety and tolerance of treatment. With a dynamic observation, the establishment of personal contact between the doctor and the patient, training of patients in schools for patients with hypertension, which increases the commitment of the patient to treatment is crucial.

Sartans in arterial hypertension are special preparations that are intended to block the receptors to angiotensin II. It is this component that causes spasm of vessels and an increase in blood pressure.

1. Hypertonic disease. This is the main indication for the reception of the drugs under consideration, because their action is directed primarily on the normalization of blood pressure.
2. Heart failure arising from the excessive activity of enzymes that increase blood pressure. Apply drugs most often at the initial stage of pathology, in which they are able to bring the heart to normal.
3. . The disease is a kidney damage characterized by low separation of protein with urine. The pathological process is quite dangerous for a person. Often it occurs on the background arterial hypertension and diabetes. With the help of sartans, it is possible to slow down the development of renal failure.

It is advisable to take drugs in a particular situation, to solve only your doctor. Sartan independently assign yourself in no case.

Sartans - a strong medication and the feasibility of its use determines only the doctor

Classification of drugs

Sartans with arterial hypertension are several types. They differ from each other from what they consist. Select such varieties of drugs:

• Bifenyl derivatives of Tetrazole.
• Tetrazole nebiffenyl type derivatives.
• Non-cyclic compounds.
• Nebiffenyl tetrazole.

Also appeared in pharmacies of Sartan new generation, which were slightly improved. These include Telmisartan, which is produced under the brand name "Mykardis", Hipotel.

How do you act?

The action of sartans is aimed at reducing blood pressure. A hypotensive effect is achieved due to the fact that the active substance of drugs blocks receptors to angiotensin II. This allows you to normalize the state blood vessels, expand them, reset an excess load from the heart. All this helps stabilize blood pressure.

In addition to Hell Sartan, the body is protected from complications that may arise due to hypertension. Medicines help protect the work of the kidneys, vessels, hearts, visual organs, brain.

Contraindications

It is not allowed to take sartans in arterial hypertension in the following cases:

1. Cheating a child.
2. Breastfeeding baby.
3. Childhood.
4. Stenosis of kidney vessels.

Also, you should not use the means to people who have the individual intolerance to the components of the medication.

Side effects

Sartans are well tolerated by patients, but sometimes patients face the unpleasant consequences of treatment. Each drug has its own side effects. In general, the list is as follows:

• Fast fatiguability.
• Headaches.
• Increase body temperature.
• Bouts of dizziness.
• Soreness in the region chest.
• Muscular pain.
• Pain syndrome in the joints.
• Nausea, vomiting.
• Chair disorders.
• Painful feelings in the zone of the abdomen.
• Allergic reaction.
• Dry cough.
• Powder of the nasal mucosa.

Adverse reactions The body is not found too often, but if they manifested themselves, differ in severity or worried for a long time, it is worth stopping and consult a doctor. It may take to adjust the dosage or change the medication to the analog.

Which to choose?

What a drug from the Sartan group to choose, solve exclusively by a specialist. The medication is selected depending on the existing degree of hypertension, the presence of concomitant diseases, individual characteristics of the body and other factors.

Popular tools:

• "Lozartan".
• "Azilsartan".
• "Telmisartan".
• "Eprosartan".
• "Irbesartan".

All of them have the same therapeutic effect, but have different composition.

Instructions for use

Sartan is allowed to take only the appointment of the attending doctor. The specialist itself determines the optimal dosage, frequency and duration of the reception, based on the instructions for the use of a means.

Drink a pill once a day. This is quite enough, therefore the action of the medication is preserved for a long time. Take pills need inside, drinking enough water.

About 4 weeks of treatment with sartans, patients manage to achieve a resistant reduction in blood pressure.

Compatibility with other drugs

When developing the hypertension, the doctor is usually prescribed to patients with a combination of drugs. At the same time, you should know with what medications you can take sartans, and with what - no. Sartans are combined with such medicines as:

• Diuretics. Together with them, a stronger therapeutic effect is achieved with elevated arterial pressure.
• Beta blockers, antiarrhythmics. Their combination with sartans is possible if the patient suffers from heart rate disorders.
• Nitrates. Simultaneous reception with them is required if there is a man of angina.
• Antiagregants. They are used in violations in the heart of the heart, are perfectly combined with sartans.

Take Sartans together with ACE inhibitors should not be, because there is no point in that. Almost the same effect in both drug groups.

There are a number of drugs with which Sartan is not recommended. These include the following:

1. Nonteroidal anti-inflammatory funds.
2. Estrogens.
3. Lithium preparations.
4. Medicines in which there are ethanol.
5. KaliSiberid medicines.

When prescribing the drug, the doctor should take into account the features of drug interaction.

Not all drugs are compatible with each other, so the independent purpose of Sartan is prohibited

Benefits of Sartan

Sartans have high efficiency, help to quickly normalize blood pressure and maintain it normally for a long time. The following advantages of drugs are also noted:

• Effective elimination of symptoms in patients.
• Reducing the risk of stroke development.
• Preventing the occurrence of atherosclerotic vascular disease.
• Reducing the likelihood of atrial fibrillation attack.
• Good tolerant patients who are in old age.
• Lack of adverse effects on intimate function.

Thus, sartans are medicines that block the receptors to angiotensin 2, thereby reducing blood pressure. Preparations have their own features of application, side effects and contraindications, therefore take strictly to appoint a doctor.

Sartans in arterial hypertension - the use of drugs, mechanism of action and contraindications

A deep study of the pathological states of the cardiovascular system made it possible to create receptor blockers to provoking high pressure angiotensin II, known to patients as sardans in arterial hypertension. The main purpose of such drugs is the correction of blood pressure, each jump of which brings the offensive of serious problems with the heart, kidneys and brain vessels.

Sartans belong to the group of inexpensive drugs that reduce blood pressure.

In persons predisposed to hypertension, these medicines become an integral component of stable vital activity, significantly improving longevity prospects.

In the composition of drugs there are components that have a corrective impact on pressure throughout the day, they prevent the offensive of hypertensive attacks and carry out the prevention of the disease.

The main indication for the use of sartans is hypertensive disease. Especially they are shown to persons who sharpen the therapy with beta blockers, because they do not affect the metabolic processes in the body.

Patients with heart failure of sartans are prescribed as a drug that slows the work of the mechanisms leading to the dysfunction of myocardium and left ventricle.

In addition to the main indications for use, there are additional factors confirming the benefit of Sartan. These include the following effects:

• ability to reduce cholesterol;
• reducing the risks of Alzheimer's disease;
• strengthening the wall of the aorta, which serves as an additional protection against the effects of hypertension.

Mechanism of action

With oxygen fasting and lowering blood pressure, a special substance is beginning to form in the kidneys - renin, which transforms angiotensinogen to angiotensin I.

Preparations affect these receptors, not allowing hypertensive trends.

Due to the high efficiency in the treatment of hypertensive crises, Sartans have occupied an independent niche and are considered as an alternative to the IAPF (inhibitors of an angiotensin glider enzyme), previously prevailing the prevention and treatment of different stages of hypertension. The proven benefits of drugs include:

• improving symptoms in patients with cardiac metabolic failure;
• reducing the risk of stroke, atherosclerosis;
• reducing the likelihood of atrial fibrillation attack;
• efficient and continuous blocking of the actions of angiotensin II;
• lack of accumulation in the Bradikinin body (which provokes a dry cough);
• good tolerance of elderly persons;
• no negative impact on sexual functions.

List of drugs

The use of Sartan has found wide demand in medicine practicing various methods of therapy with an increase in blood pressure. The list of well-known and used funds in secondary hypertension includes:

• Lozartan: Renikard, Lotter, Prezartan, Lorist, Losakor, Losarel, Kozar, Lozap.
• Valsartan: Tareg, Northwan, Tantordio, Valsakor, Diva.
• Eprosartan: Tevevent.
• Irbesartan: Company, IberTan, Approvnel, Irsar.
• Teleminsartan: Primetor, Macardis.
• Olmertan: Olimestra, Cardosal.
• Kandesartan: Ordiss, Kandesar, Hyposart.
• Azilsartan: Earbie.

By the first generation, those drugs that have an action exclusively on the hormonal system that is responsible for blood pressure (RAAS) through blocking of sensitive AT 1 receptors is rated.

Sartans of the second generation Bifunctional: they suppress undesirable manifestations of RAAS and have a positive effect on pathogenetic algorithms of violation of the exchange processes of lipids, carbohydrates, as well as inflammation (non-infectious) and obesity.

Specialists confidently argue that the future of Sartan antagonists in the second generation.

Telmisartan.

A popular drug that is included in the group of angiotensin receptor blockers is televisartan.

Indications for the use of this antagonist are the prevention of cardiovascular diseases and treatment of essential hypertension, it reduces cardiocyte hypertrophy, reduces the level of triglycerides.

Tablets are accepted inside, regardless of food intake, in elderly patients and liver failure, the dose correction is not carried out.

The recommended dosage is 40 mg per day, sometimes it can decrease to 20 mg (renal failure) or increase to 80 (if systolic pressure does not fall persistently). Telmisartan is well combined with thiazide diuretics. The course of treatment lasts about 4-8 weeks. At the beginning of therapy, blood pressure should be monitored.

When using sartans in arterial hypertension, doctors note their good tolerability and the absence of specific side effects compared to other groups of drugs.

Possible manifestations A negative nature, according to reviews, the allergic reaction becomes headache, dizziness, insomnia.

Rarely noted the increase in body temperature, cough, sore throat, runny nose.

In some cases, sardans from pressure are able to cause nausea, vomiting, constipation, Malgia. Contraindications for the use of medicines are:

• pregnancy, breastfeeding, children's age due to lack of data on efficiency and safety;
• renal failure, stenosis of renal vessels, diseases of the kidneys, nephropathy;
• individual intolerance or increased sensitivity to components.

Sartan and cancer

Scientists have revealed that the hyperactivity of angiotensin provokes the occurrence of malignant tumors.

Sartans are angiotensin receptor blockers, therefore suppress and prevent the development of many types of cancer in patients with increased arterial pressure and even with diabetes mellitus.

Sometimes drugs can be used during chemotherapy with already discovered malignant neoplasms - they enhance the delivery of drugs by unpacking tumor vessels. Sartans show activity regarding the prevention of the following types of cancer:

• gyoma;
• colorectal cancer;
• tumors of the stomach, lungs, bladder, prostate, pancreas;
• cancer endometrial, ovarian.

Often patients with arterial hypertension have concomitant diseases that require the appointment of combined drugs. In this regard, it should be aware of the compatibility of medicines with appointed sartans:

• Unwanted combination of sartans with ACE inhibitors due to the same mechanism of action.
• The appointment of diuretics (diuretic products), drugs with ethanol, antihypertensive drugs can enhance the hypotensive effect.
• Nonteroidal anti-inflammatory products, estrogens, sympathomimetics weaken their effectiveness.
• Potassium diuretics and potassium-containing drugs can lead to hyperkalemia.
• Lithium preparations lead to an increase in blood lithium concentration, increase the risk of toxic effects.
• Warfarin reduces the concentration of sartans, increases prothrombin time.

The information presented in the article is familiarized. Articles do not call for independent treatment. Only a qualified doctor may diagnose and give recommendations on treatment based on the individual characteristics of a particular patient.

A new generation of sartan medicines cause deep interest in practicing cardiologists. Medicines of this category are prescribed by patients with arterial hypertension (AG).

Numerous studies have discovered the great opportunities of these dosage forms.

What about Sartan is already known to scientists and practices? What attractive these medicines for patients? We will try to answer these questions from the position of the most recent data.

What it is

Sartans are called angiotensin II receptor blockers (Bras, Bran). Angiotensin II is a very active compound, derivative of the activity of the Renin-angiotensin-aldosterone system (RAAS).

He calls:

• Severe narrowing of blood vessels;
• Increase resistance to peripheral vessels;
• Fast increase in blood pressure.

Other negative effects of this peasis peptide are also known, which lead to changes in various organs.

It serves as a source of development:

• Kidney damage;
• Atherosclerosis of brain vessels;
• Myocardial hypertrophy and others.

Speaking by antagonists of the A-II receptors, Sartan controls not only blood pressure, but also many other states and diseases.

Groups

There are various classifications blockers A-II. Substances are divided into groups in chemical composition and action on the body.

Taking into account the last generation of compounds, such a classification is proposed:

• Tetrazole biphenyl derivatives - losartan, Kandesartan, Irbesartan, Tazosartan;
• Tetrazole compound Nebiffhenyl - Teleminsartan;
• Netzolezol Nebiffenyl - Eprosartan;
• Non-meterocyclic compounds - Valsartan;
• New derivative - Olmertan.

These are basic medicines. The pharmaceutical industry sells sartans for monotherapy, combined drugs, a list of which is very impressive. They are known in many trade names.

Pharmacies offer combinations in which the A-II receptor antagonists are combined with an alianis (inhibitor of the Renin secretion), calcium blockers, with diuretics (diuretics).

The scope of the application of sartans in the medical business is diverse.

AT1 receptor antagonists give a good effect with such states and diseases:

• Arterial hypertension;
• Heart failure;
• Coronary artery disease;
• Myocardial infarction;
• Violation of cerebral circulation;
• Diabetes;
• Nephropathy;
• Atherosclerosis;
• Miodistrophia;
• Sexy dysfunction.

All antihypertensive drugs, famous for modern medicine, have full right to appoint. They are used in monotherapy, in combination with other medicines. Their purpose determines the mechanism of action, the sensitivity of the patient to the drug. A-II antagonists are used when they are more preferable under certain conditions.

Among the hypotensive forms, angiotensin II receptor blockers occupy the first position in this case:

• Improving the systolic pressure indicator;
• Arterial hypertension associated with violations of cerebral circulation;
• Non-interity of angiotensin glittering enzyme inhibitors (IAPF);
• Hypertension plus diabetes mellitus complicated with diabetic nephropathy.

Contraindications

Contraindications

Medical experts appoint Sartan to people who have such problems:

1. Hypertension, which is the main indicator for their use.
2. Heart failure, which can develop against the backdrop of the superchactive renin-angiotensin-aldosterone system. At an early stage, it allows you to normalize the heart function.
3. Nephropathy is a dangerous consequence of diabetes, arterial hypertension. For the disease there is a decrease in the number of proteins allocated with urine. Medicines contribute to the slowdown in the development of renal failure.

Such drugs do not affect the metabolism, the permeability of the bronchi, the organs of vision. In rare cases, it can cause a dry cough, an increase in potassium level. The effect of the use of medicines will be visible in a month.

Sartans in arterial hypertension most often do not cause a side reaction, but sometimes patients may mark such problems:

• dizziness;
• the appearance of sudden pain in the head area;
• a dream is disturbed;
• the temperature increases;
• nausea, accompanied by vomiting;
• constipation or diarrhea;
• it gets itching.

Therapy should be only under the supervision of the attending physician. It is forbidden to receive drugs during the rigging of the child and breastfeeding, you can not give them to children. With great care, medications are allowed to use patients suffering from renal pathology, as well as elderly people.

The doctor selects the patient a dosage individually, which guaranteed quickly leads to a good result, which is preserved for a long time.

1. Hypertonic disease. This is the main indication for the reception of the drugs under consideration, because their action is directed primarily on the normalization of blood pressure.
2. Heart failure arising from the excessive activity of enzymes that increase blood pressure. Apply drugs most often at the initial stage of pathology, in which they are able to bring the heart to normal.
3. Nephropathy. The disease is a kidney damage characterized by low separation of protein with urine. The pathological process is quite dangerous for a person. Often it occurs against the background of arterial hypertension and diabetes. With the help of sartans, it is possible to slow down the development of renal failure.

It is advisable to take drugs in a particular situation, to solve only your doctor. Sartan independently assign yourself in no case.

Sartans - a strong medication and the feasibility of its use determines only the doctor

It is not allowed to take sartans in arterial hypertension in the following cases:

1. Cheating a child.
2. Breastfeeding baby.
3. Childhood.
4. Stenosis of kidney vessels.

Also, you should not use the means to people who have the individual intolerance to the components of the medication.

Sartan is allowed to take only the appointment of the attending doctor. The specialist itself determines the optimal dosage, frequency and duration of the reception, based on the instructions for the use of a means.

Drink a pill once a day. This is quite enough, therefore the action of the medication is preserved for a long time. Take pills need inside, drinking enough water.

About 4 weeks of treatment with sartans, patients manage to achieve a resistant reduction in blood pressure.

Sartans are well tolerated. They do not have any specific side effects, as in other groups of drugs (for example, cough when using an angiotensin surgery enzyme inhibitors). Wood, like any medicines, can cause an allergic reaction.

These drugs sometimes cause headaches, dizziness, insomnia. In rare cases, their use is accompanied by an increase in body temperature and the development of signs of respiratory tract infection (cough, throat pain, runny nose).

They are able to cause nausea, vomiting or abdominal pain, as well as constipation. Sometimes pain in the joints and muscles appear after receiving drugs of this group.

There are also other side effects (from the side of the cardiovascular, urogenital system, skin), but their frequency is very low.

Sartans are contraindicated in childhoodduring pregnancy and lactation. With caution, they should be used in the diseases of the liver, as well as during the stenosis of the renal arteries and severe renal failure.

Groups

As a rule, the scab is transferred to patients well. Inhibitors of APF and Sara (Sartanes) are characterized by a comparable effect in reducing pressure. However, AT-receptor blockers, in contrast to the IAPF, do not cause obsessive cough.

The risk of developing and progressing diabetes against the background of the course of angiotensive receptor inhibitors does not increase, the metabolic profile remains unchanged.

The sconium is usually shown to people with proteinuria, which develops a dry cough as a response to ACE inhibitors.

With renal / hepatic dysfunction, the sconce is prescribed in reduced doses with monitoring of the main indicators. The same applies to patients with 2-sided stenosis of renal arteries and hypercalemia.

In individuals of the elderly, taking sartans, hypotonia, disorders of the liver and kidney function may appear (this slows down the removal of the sconium from the body).

Common side effects include Malgy, diarrhea, dizziness, peripheral edema. More dangerous pressure drop below the norm and high level Potassium in the blood.

The aggravation of renal dysfunction is not excluded. In contrast to ACE inhibitors, the sconium rarely cause cough.

Screws are contraindicated with individual hypersensitivity, in pregnant, lactating women, in children, as well as with severe liver and kidney dysfunctions, in cases of aldosteroneism, with deviations from the norm of blood electrolyte concentration (potassium, sodium), after kidney transplantation, during the stenosis of the renal arteries.

To eliminate the presence of contraindications and the occurrence of side effects, before the beginning of the therapeutic course, the patient must be consulted by a cardiologist or therapist.

Telmisartan is one of the drugs of the Sartan group, which, in addition to lowering blood pressure through the blockade, has an additional property - agonism to PPAR receptors. Wild-type mice, with long-term reception of televisartan, there is an increase in endurance in running, a decrease in fat deposits and an increase in the share of muscle fibers of type I.

And besides, it was shown that the preparations of the IAPF Group reduce mortality in the elderly, and Sartans in older mortality do not reduce or reduce badly. But Telmisartan reduces mortality as well as the champion on this indicator among the drugs of the IAPP group - Ramipril.

For televisartan in large randomized controlled blind placebo studies, effectiveness is proved in protection against the development of heart attack and stroke and mortality from them as a result of atherosclerosis, as well as in Ramipril - "Golden" standard. Teleminsartan reduces hypertrophy of the left ventricle of the heart (see table left).

• www.ncbi.nlm.nih.gov/pubmed/21504246.
• www.ncbi.nlm.nih.gov/pubmed/22011630

Teleminsartan, unlike other sartans, is a partial PPARγ and PPARδ receptor agonist (Peroxisome Proliferator-Activated Receptor). This allows you to increase insulin sensitivity, promote the prevention and treatment of 2-type diabetes mellitus, reduce cholesterol and improve lipid spectrum. Of all the Sartan Telmisartan - the most powerful activator PPAR is stronger than Lozartan about 20 times (see picture on the left). Teleminsartan is a drug reduced pressure and a drug for the treatment of type 2 diabetes in one molecule.

Sartans in arterial hypertension are drug-antagonists to angiotensin II. Such medicines are well combined with almost any means against high blood pressure and practically do not cause side effects.

Sartans are medicinal products of the new generation, the purpose of which is to reduce blood pressure indicators when it is raised. They stop the receptors to angiotensin II, thus reducing blood pressure.

The principle of Sartan's action is that their active substances block receptors that contribute to the transformation of inactive angiotensinogen in angiotensin II - a substance that stimulates a rapid and long-term increase in blood pressure.

Sartans prevent the development of hypertensive seizures and improve pathology forecast.

Sartanes are prescribed at:

• hypertensive disease;
• heart failure;
• acute myocardial infarction;
• nephropathy (severe kidney damage).

Preparations from a group of sartan possess the following therapeutic effects:

• slow down negative processes that disturb the functions of myocardium and left ventricle;
• defend the kidneys;
• strengthen the walls of the aorta;
• prevent the loss of protein by the body;
• prevent the development of the dangerous consequences of hypertension;
• reduce cholesterol content;
• reduce uric acid indicators in blood;
• reduce the likelihood of alzheimer's disease, as well as atherosclerosis and stroke.

The advantages of such medicines are:

• the lack of influence of drugs on the function of genital organs and potency;
• persistent effect;
• improving lipid metabolism;
• lack of dependence and addiction to drugs even under the condition of long-term admission;
• providing additional protection to the cells of the nervous system;
• thieves of old age are well tolerated these drugs when taking.

Sartanes have such additional clinical effects as a decrease in the risk of developing type 2 diabetes or correction of the patient's condition, if this disease is already available, as well as an antiarrhythmic effect.

Persons suffering from hypertension are well tolerated by the preparations of the Sartan group. Side effects rarely occur. The most pronounced effect of drug intake is achieved within 2-4 weeks after the start of reception.

These types of drugs from the Sartan group are distinguished, based on their chemical composition:

• biphenyl derivatives of tetrazole (losartan);
• non-cyclic compounds (valsartan);
• nebiffenyl tetrazole derivatives (Teleminsartan);
• nebiffenyl Netztrazole (Eprosartan).

There are a large number of items of drugs of this group. Specific species is selected only by a doctor who pre-evaluates general state patient.

This drug is characterized by a long action (24 hours or more). The maximum hypotensive effect is expected after 3-6 weeks after the start of the use of the drug. The main active substance is Lozartan. In addition to reducing blood pressure, Renikard reduces the risk of progression of diseases of the cardiovascular system.

The use of tablets is prohibited during periods of pregnancy and lactation, in childhood. Take pills once a day, daily dose is 50 mg. The cost of the medicinal product is about 350 rubles.

Macardis

The drug is produced on the basis of telemisartan. The drug has a pronounced hypotensive effect. Tablets are prescribed to patients in the mortality group from cardiovascular diseases, including aged 55 years and older.

At elevated pressure, the initial dose will be 1 tablet per day. (Dosage - 40 mg). The price of the drug is 1050 rubles (28 tablets).

Belongs to the non-cyclic sartan group. Suitable as a means to prevent the development of repeated heart attack.

With arterial hypertension, standard day dosage is 80 mg of the drug. It is increased only if the expected therapeutic effect is achieved. The cost of the drug is about 350 rubles.

Active substance - Lozartan Potassia. The drug allows you to stabilize blood pressure, and is also a preventive tool in the threat of heart failure.

The drug lowers the peripheral resistance of the vessels, reduces the concentration of adrenal hormones in the blood plasma, reduces the pressure in the pulmonary circulation.

Lozartan is also characterized by a diuretic effect and due to this removes urinary acid from the body and sodium salts, the excess of which can cause an increase in blood pressure.

You need to take one tablet of the drug daily. The cost of funds is about 150 rubles per pack.

Eprosartan

The drug has not only a hypotensive, but also diuretic effect. This medicinal product must be taken once a day in a dosage from 600 to 800 mg. The maximum decrease in blood pressure when taking EPROSARTAN is observed after 14-22 days from the start of the course of therapy.

With extreme caution, the drug is prescribed with ischemic heart disease, severe heart failure. The cost of EPROSARTAN is about 850 rubles.

Drugs Sartans are forbidden to be taken with the following pathologies or states:

• increased susceptibility of the organism to any acting agent drug;
• age up to 18 years;
• pregnancy and breastfeeding period;
• renal failure;
• dehydration of the body;
• elevated level of potassium content in the body;
• cirrhosis of the liver;
• violations electrolyte composition blood;
• nephropathy.

The likely side effects from the reception of drugs of the Sartan group are:

• nausea;
• dizziness;
• stomach ache;
• skin itch;
• vomiting;
• pain in the muscles and joints;
• temperature increase;
• constipation;
• heartburn;
• painfulness in the field of chest;
• allergic skin reactions;
• cefalgia.

Despite the likelihood of developing negative reactions, they are rarely manifested. In contrast to many drugs similar action, Sartans do not provoke the appearance of an unproductive painful cough.

Sartans are well combined with other drugs against increased blood pressure. The most effective combination is the preparations of a group of sartans and diuretics or calcium antagonists.

The combination of these drugs does not only increase the effectiveness of therapy, but also reduces the likelihood of the development of side effects to a minimum. Also diuretics reduce sodium level in the body.

Thanks to this effect, patients often prescribe a combined reception of sartans and diuretics.

Simultaneously with the sartans, if necessary, you can take antiarrhythmics, antiagregants, beta blockers.

It is undesirable to combine sartan tools and ACE inhibitors, since the mechanism of their action is almost similar.

Classification of Sartan

Developed several types of color classification:

• by chemical structure;
• focusing on the features of pharmacokinetics;
• according to the mechanism of compound with receptors.

The classification of medicines (such as sartans) in the structure of the substance is such. Distinguish drugs 4 groups:

• tetrazole heterocycles are cozy to biphenyl aromatic compounds (Lozartan, Irbesartan, Kandesartan);
• tetrazole heterocycles of nebiffenyl compounds ("Teleminsartan");
• nettrazole heterocycles (nebifenyl group of type "EPROSARTAN");
• neverocycles ("Valsartan").

Distinguish among Sartans:

• prodrugs (predecessors of drugs; do not possess independent activity);
• active dosage forms.

The first group includes, for example, "Candesartan Tsiletyl". This means, being taken inside and undergoing metabolic transformations in the liver, becomes active, able to provide therapeutic impact.

The sconium differ in the ability to form active metabolites. Thus, one of the representatives of Sartan "Lozartan" during oral administration quickly digested in the gastrointestinal tract and when passing through the liver joins the carboxyl group, forming an active metabolite of the drug "Losartan" (its exact name - EXP-3174) is 40 times more active, It acts with a more significant effect than the drug itself. Such metabolite is formed from "Tazosartan".

According to the nature of the influences of Sartan's AT-AT-Cartan receptors (and their metabolites) are classified into 2 categories: having a competitive mechanism of action and non-competitive (classification for communication "LS-receptor").

The first category includes "EPROSARANTAN" and "Lozartan", forming a temporary, reversible connection with receptor sites (under some conditions leave the binding sites and release the receptor).

Non-competitive (that is, forming irreversible, durable communication) are "Valsartan", "Kandesartan", "Irbesartan", "Telmisartan", as well as active metabolite of Lozartan.

Conduct the preparations of sconces - first of all means to compare sartans according to the strength of antihypertensive action. As a result, their comparative characteristics will show the differences in a maximum of 2 mm Hg. on diastolic and systolic blood pressure.

Preparations of sartan differ from each other durability of action. All the sconces that appeared after Lozartan are capable of more than 10 times more efficiently contact receptors.

Such differences affect the severity of the clinical effect and its duration. Thus, Valsartan has a therapeutic effect of approximately 24 hours, "Telmisartan" - more than 24 hours (Lozartan - only 12 hours).

It should be noted that Lozartan has the ability to increase the renal removal of uric acid, has the greatest evaluating base of use in hyperuricemia and non-alcohol liver disease.

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It is believed that the most effective medicines from hypertension are sardans, they differ next to the advantages:

• the dependence on long-term reception does not appear;
• {!LANG-4b745f9fbeec3661a072555333b8265f!}
• well tolerated and have a minimum of negative consequences.

Also, the preparations improve renal functioning in diabetic nephropathy, guarantee the regression of the hearty hypertrophy and lead in terms of heart failure to normal.

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Additional impact of medication data:

1. {!LANG-207c5fb5c1d71e0115ada99da1910012!}
2. The threat of paroxism of atrial fibrillation is reduced, which is ensured by the help of antiarrhythmic effects.
3. The risk of diabetes is reduced. For this, the metabolic effect corresponds to this, and in the presence of this disease, the patient's condition will be coming back, as the insulin resistance of the tissues is carried out.

Some sartans are beneficial for marfan syndrome, they strengthen the vessels and have prevention of their possible rupture. Also normalizes muscle state. Such an impact has "Lozartan".

The cost of drugs depends on the manufacturer company, the duration of action. Using the cheapest drugs, the patient must understand that they are required to drink more often, as they differ in short exposure.

Preparations are divided according to the composition and exposure. Doctors divide them on prodrugs and active substances, based on the availability of active metabolite. By chemical composition, Sartans are:

Without a recipe, all these funds can be purchased in specialized items. In addition, the pharmacies offer ready-made combinations.

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What it is

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• Fast fatiguability.
• Headaches.
• Increase body temperature.
• Bouts of dizziness.
• {!LANG-1faa1981f59f65e9e596863650fe4fd2!}
• Muscular pain.
• Pain syndrome in the joints.
• Nausea, vomiting.
• Chair disorders.
• Painful feelings in the zone of the abdomen.
• Allergic reaction.
• Dry cough.
• Powder of the nasal mucosa.

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When developing the hypertension, the doctor is usually prescribed to patients with a combination of drugs. At the same time, you should know with what medications you can take sartans, and with what - no. Sartans are combined with such medicines as:

• Diuretics. Together with them, a stronger therapeutic effect is achieved with elevated arterial pressure.
• Beta blockers, antiarrhythmics. Their combination with sartans is possible if the patient suffers from heart rate disorders.
• Nitrates. Simultaneous reception with them is required if there is a man of angina.
• Antiagregants. They are used in violations in the heart of the heart, are perfectly combined with sartans.

Take Sartans together with ACE inhibitors should not be, because there is no point in that. Almost the same effect in both drug groups.

There are a number of drugs with which Sartan is not recommended. These include the following:

1. Nonteroidal anti-inflammatory funds.
2. Estrogens.
3. Lithium preparations.
4. {!LANG-4addb63edcae24521f0bba8ffd6c9bdb!}
5. KaliSiberid medicines.

When prescribing the drug, the doctor should take into account the features of drug interaction.

Not all drugs are compatible with each other, so the independent purpose of Sartan is prohibited

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