Sartans

Sartans are very familiar to internal physicians. These drugs belong among frequently prescribed antihypertensives. To be more precise, sartans should be called angiotensin II receptor antagonists.

Principle

The active substances in sartans affect the metabolism by successfully blocking receptors of a substance known as angiotensin II. Angiotensin II increases the blood pressure and affects the renal secretion of minerals into the urine (increase sodium excretion and decrease potassium excretion). In addition, angiotensin II affects other organs such as the heart and kidneys. Effect of sartans is similar to the effect of ACE-inhibitors. However, the ACE-inhibitors are more effective, because the block the formation of angiotensin II alone.

Indications

Angiotensin II receptor antagonists are used to treat high blood pressure. Due to their overall positive effect on heart and kidneys, they are appropriate when the patient has renal impairment (e.g. diabetic nephropathy in diabetes), or a heart disease (heart attack in personal history, cardiomyopathies, etc.). Because the ACE-Inhibitors have similar indication and they are more effective, we used sartans mainly in situation when the ACE-Inhibitors can not be used. This is mainly in cases of unpleasant dry cough, which is a typical side-effect of ACE-Inhibitors, but which is not present in sartans usage.

Used substances

There are a number of used substance, their names usually ends with the same suffix -sartan. I should mention only the most commonly used - losartan, valsartan and irbesartan. Sartans are also used in many combined preparations, usually with another antihypertensive such as a diuretic agent.

Disadvantages

Side effects are not common and usually not serious. They may cause hypotension with dizziness, weakness and fainting. Combination of sartans with other medications (typically with spironolactone) may cause retention of potassium in the body, which may cause serious hyperkalemia. Angiotensin II receptor antagonists should not be administered during pregnancy and in breast-feeding women.