Cardiovascular and Renal Review: Pharmacology of Angiotensin II Receptor Antagonists: Comparison with Renin Inhibitors and Angiotensin-Converting Enzyme Inhibitors

Nonpeptide angiotensin II (ANG II) receptor antagonists are a new class of inhibitors of the renin angiotensin system (RAS). Several ANG II receptor antagonists are currently in clinical development for the treatment of hypertension and heart failure. The discovery of these compounds follows many years of research on renin and the spectacular success of angiotensin converting enzyme (ACE) inhibitors, both as therapeutic agents and pharmacological tools. By inhibiting the interaction of ANG II with its receptor(s), studies utilising ANG II receptor antagonists have furthered our understanding of the RAS. This class of compounds may provide an interesting alternative to ACE inhibitors for the clinical management of hypertension and heart failure. The present article examines the comparative preclinical pharmacology of ANG II receptor antagonists, ACE inhibitors and renin inhibitors, with two objectives: 1) to demonstrate how our knowledge of the RAS has been extended utilising these three classes of pharmac...