Analysis of Antihypertensive Drugs Used in Shanghai Sample Hospitals

Lead

Hypertension (hypertension) is characterized by increased systemic arterial blood pressure (systolic and/or diastolic blood pressure) (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg), which may be accompanied by heart, brain, kidney, etc.

There are a large number of people with hypertension.

For hypertensive patients, how to control blood pressure is very important

Common antihypertensive drugs

In 2020, the top ten antihypertensive drugs commonly used in Shanghai sample hospitals include: L-Amlodipine, Amlodipine, Valsartan, Metoprolol, Losartan Potassium Hydrochlorothiazide, Irbesartan Hydrochlorothiazide, Telmisartan , Felodipine, Losartan, Candesartan (see Table 1)

Table 1.

Data source: China Pharmaceutical Industry Information Center Hospital Prescription Analysis System (RAS)

The top four drugs with the most dosage are L-Amlodipine, Amlodipine, Valsartan, and Metoprolol.

Figure.

Data source: China Pharmaceutical Industry Information Center Hospital Prescription Analysis System (RAS)

From the perspective of drug categories, the most commonly used antihypertensive drugs are L-Amlodipine, which accounts for 2.

Followed by prescriptions accounted for 2.

In addition, β-blockers antihypertensive drugs, such as metoprolol, which accounts for 2.

Analysis of manufacturers of antihypertensive drugs

As shown in Table 2, the current antihypertensive drugs used in Shanghai sample hospitals are domestically produced and imported.

Table 2.

Data source: China Pharmaceutical Industry Information Center Hospital Prescription Analysis System (RAS)

New sartan antihypertensive drugs: Olmesartan medoxomil, Allisartan medoxomil

Based on the above data, dihydropyridine CCB and Pristine/sartan ARB are the main antihypertensive drugs

In recent years, olmesartan medoxomil and allisartan medoxomil are relatively new antihypertensive drugs

Allisartan medoxomil is the antihypertensive metabolite EXP3174 of Losartan Potassium.

Because the new sartan antihypertensive drugs not only have the antihypertensive effect of angiotensin-converting enzyme inhibitor antihypertensive drugs, they can also improve ventricular remodeling, reverse myocardial hypertrophy, reduce heart failure, and do not affect the metabolism of blood sugar and blood lipids.

Compared with other established antihypertensive drugs, allisartan medoxomil has the following advantages:

Smooth antihypertensive effect

Allisartan medoxomil, like other "sartan" drugs, has a stable antihypertensive effect and a slower onset.
It usually takes several weeks to achieve the maximum effect and is suitable for long-term use
.

In the clinical study of "The Observation of the Efficacy of Allisartan Medoxomil in the Treatment of Hypertension Complicated with Stable Angina Pectoris", allisartan medoxomil has a better blood pressure lowering effect than irbesartan.
It can reduce the frequency of angina in patients with hypertension and stable angina
.

Lower blood pressure and lower uric acid at the same time

Allisartan medoxomil can inhibit the uric acid transporter in the renal tubules, thereby preventing the reabsorption of uric acid.
While lowering blood pressure, it also has the effect of lowering uric acid, reducing the risk of gout
.
In the clinical observation of "Comparison of the effects of allisartan medoxomil and valsartan in the treatment of hypertension with hyperuricemia", allisartan medoxomil and valsartan have the same effect in lowering blood pressure, and allisartan medoxomil tablets are used to treat hypertension.
Combined with hyperuricemia, the clinical effect is definite, and it can significantly reduce uric acid
.

Intestinal metabolism, reducing the burden on the liver

Unlike other sartan antihypertensive drugs, it is not metabolized by the liver, but absorbed through the gastrointestinal tract, and can be hydrolyzed by hydrolytic esterase into the active metabolite 5-carboxylate Losartan (EXP-3174) in the body.
It works, which is similar to Losartan
.
Because it is not metabolized by the liver, it can significantly reduce the burden on the liver of hypertensive patients
.
After oral absorption, Losartan needs to be metabolized by CYP2C9 and CYP3A4 enzymes in the liver, while Allisartan medoxomil is hydrolyzed by esterases in the gastrointestinal tract without liver drug enzyme metabolism, so it can greatly reduce the liver burden of hypertensive patients
.

Few adverse reactions

Allisartan medoxomil is well tolerated, and the general adverse reactions are mild and short-lived.
Headache and dizziness are common
.
And because it is not metabolized by the liver, it will not interact with the liver drug enzyme metabolism drugs such as clopidogrel, warfarin, atorvastatin, and so on, which also reduces the risk of adverse reactions
.

Reference materials:

1.
A new type of sartan drug independently developed by our country, which has a long-term and stable effect on lowering blood pressure, lowering uric acid, and hardly hurts the liver.
Chronic Disease Management Network

2.
Classification and selection of commonly used antihypertensive drugs, Dingxiangyuan

3.
China Pharmaceutical Industry Information Center Hospital Prescription Analysis System (RAS)