Angiotensin II Receptor Blockers (ARBs) = Sartans

Angiotensin II receptor blockers (Sartans, AT1 receptor antagonists or AT1 blockers) such as Candesartan, Irbesartan, Losartan, Olmesartan, Telmisartan, or Valsartan are often used as blood pressure medication when dry cough or other side effects of an ACE inhibitor have occurred. They work similarly to ACE inhibitors but do not hinder the breakdown of bradykinin. Unlike ACE inhibitors, ARBs do not block the conversion of Angiotensin I to Angiotensin II but act directly at the receptor. The receptors where Angiotensin II can bind are distinguished into two subtypes: AT1 and AT2 receptors. A blood pressure-increasing effect occurs mainly through the binding of Angiotensin II to an AT1 receptor. This causes the smooth muscle of the blood vessels in the arterioles to contract, thereby increasing the blood pressure. A second, AT1 receptor-mediated and blood pressure-increasing effect occurs in the kidney. Here, the hormone aldosterone causes less water to be excreted through the kidneys, which in turn leads to an increase in blood pressure due to the larger blood volume.

ARBs/Sartans do not inhibit the formation of Angiotensin II but block at the site of action (receptor) of Angiotensin II - the subtype 1 of the Angiotensin II receptors (hence AT1 blockers). Therefore, no Angiotensin II can bind here. The vasoconstrictive and thus blood pressure-increasing effect of Angiotensin II is reduced in this way. The kidney-related effect through the hormone aldosterone is also interrupted.
Since the conversion of Angiotensin I to Angiotensin II is not prevented, bradykinin can be broken down unhindered. This significantly reduces the occurrence of the dry cough that often occurs under ACE inhibitor therapy.

Especially at the beginning of treatment, there can be a significant drop in blood pressure, leading to dizziness, fatigue, and headaches. Additionally, ARBs can also lead to an increased potassium level in the blood. They are a good alternative to ACE inhibitors, as dry cough is observed much less frequently. Angioedema (swelling of the skin) also occurs less frequently than with ACE inhibitors. However, due to the higher price, they are usually only prescribed when the ACE inhibitors show side effects in the patient.

Please also refer to the package insert of your preparation for a complete list of side effects.

Azilsartan, Candesartan, Eprosartan, Irbesartan, Losartan, Olmesartan, Telmisartan, Valsartan

Angiotensin II Receptor Blockers / Sartans: Examples of Active Ingredients and Approved Medicinal Substances

• https://leitlinien.dgk.org/files/28_2018_pocket_leitlinien_arterielle_hypertonie_aktualisiert.pdf
  
• https://flexikon.doccheck.com/de/AT1-Rezeptorantagonist?utm_source=www.doccheck.flexikon&utm_medium=web&utm_campaign=DC%2BSearch
  
• https://www.gelbe-liste.de/wirkstoffgruppen/at-1-antagonisten-sartane
• https://www.herzstiftung.de/infos-zu-herzerkrankungen/gerinnungshemmung-und-medikamente/sartane
  
• https://de.wikipedia.org/wiki/AT1-Antagonist
• http://www.pharmawiki.ch/wiki/index.php?wiki=Sartan

We hope you found the article on the topic helpful. For good blood pressure management, it is important to take the medications correctly. Our app BloodPressureDB is happy to remind you of the intake times. It also manages the supply and informs you in good time when it is running low. This feature is also fully available in the free version. Get the free app now.

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