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Angiotensin receptor antagonists (ARBs) and Calcium Channel Blockers (CCB) : Analysis of a Clinical Trial - Assignment Example

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Angiotensin Receptor Antagonists (ARBs) and Calcium Channel Blockers (CCB) – Analysis of a Clinical Trial [Name of Student] [Name of Institution] Introduction Often referred to as angiotensin receptor blockers (ARBs), angiotensin II receptor antagonists (AT1-receptor antagonists) are pharmaceutical products used to moderate the renin-angiotensin-aldosterone system in the body…
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Download file to see previous pages Since ARBs do not hinder the breaking down of bradykin, they are seldom linked with the dry and persistent cough and angioedema, which work against ACE inhibitor treatment.2 Besides hypertension, ARBs are currently extensively used in managing heart failure in ACE inhibitor-intolerant patients. Research findings also support the effectiveness of ARBs in benefiting type II diabetic hypertensive patients. Thus, ARBs are used to slow down the progress of diabetic nephropathy. The potencies of ARBs have been shown to vary with the level of dosage and blood pressure control. In addition, in a clinical setting, the ARB agent used depends on the extent of the expected response.3 In addition to treating hypertension, a few of these pharmaceutical products have uricosuric effects whereas some ARBs, such as losartan (Cozaar), were found to improve sexuality in 88% of hypertensive males with sexual dysfunction in a 12-week study in which subjects were treated with the ARB.3 Through AT1-receptor stimulation, angiotensin II acts as a major stress hormone.4 Given that ARBs block these receptors, they are considered for the treatment of stress-related disorders in addition to their elicitation of anti-hypertensive effects. ARBs have also been associated with a negative correlation with Alzheimer’s disease. For example, in 2008, the United States Department of Veteran Affairs analysed records of about five million patients to establish the various types of anti-hypertensive drugs used and their Alzheimer’s disease-related outcomes. It was reported that patients who used ARBs were 40% less likely to develop Alzheimer’s disease compared to those placed under other antihypertensive medications.4 Although ARBs are always well tolerated by many, they are associated with several adverse side effects such as headache, hyperkalemia and dizziness. Other less frequent adverse side effects of ARBs use are dyspepsia, rash, diarrhea, muscle cramps, back pain, renal impairment, nasal congestion, impaired liver function, lowered hemoglobin levels and pharyngitis.5 Moreover, despite ARBs being used to help avoid cough and angioedema, these conditions may still be encountered in certain situations.6 What is more, there is a chance of irritable reactivity for patients with angioedema to ACE inhibitor therapy. This paper explores angiotensin II receptor blockers (ARB) and calcium channel blockers (CCB) with respect to the pharmacology of angiotensin receptors and their therapeutic use in treating hypertension. Second, the paper summarises the design and results from clinical trials conducted to determine and ascertain the efficacy of Valsartan and Amlodipine in the treatment of hypertension.6 Further, the paper explores the theories and applications of clinical trial design with respect to the inclusion and exclusion criteria used, patient randomisation and bias minimisation.6 The other aspects of clinical trial design to be covered are Kaplan-Meier plots and hazards ratios. Mechanisms of Action Angiotensin and CCBs Formed from angiotensin I in an angiotensin-converting enzyme (ACE, kininase II)-catalysed reaction, angiotensin functions in its capacity to cause blood vessel muscles to contract, thus narrowing blood vessels and increasing the pressure of blood in these vessels, hence hypertension. Angiotensin II rece ...Download file to see next pages Read More
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