sartan

Sartans, also known as angiotensin II receptor blockers (ARBs), are a class of medications that selectively antagonize the angiotensin II type 1 (AT1) receptor. By blocking this receptor, they prevent angiotensin II–mediated vasoconstriction and aldosterone release, leading to reduced blood pressure and improved cardiovascular and renal function in various conditions.

They are primarily used to treat hypertension and are also indicated for heart failure with reduced ejection fraction, left ventricular dysfunction after myocardial infarction, diabetic nephropathy, and chronic kidney disease. ARBs are also employed as an alternative to ACE inhibitors in patients who experience cough or angioedema with ACE inhibitors, though angioedema can still occur with ARBs.

Common examples include losartan, valsartan, candesartan, irbesartan, olmesartan, telmisartan, and eprosartan. Losartan is a prodrug; its active metabolite EXP3174 contributes to its effect. The others have varying bioavailability and pharmacokinetic profiles. In practice, ARBs are often combined with diuretics or used alongside other antihypertensives to achieve blood pressure targets.

Adverse effects are generally well tolerated. Potential risks include hyperkalemia, hypotension, and changes in renal function, particularly in patients with kidney disease or those taking additional potassium-sparing medications. Angioedema is less common than with ACE inhibitors but remains a potential adverse effect. They are contraindicated in pregnancy due to fetal risk and require caution in patients with bilateral renal artery stenosis.

Developed in the late 20th century to provide alternatives to ACE inhibitors, the ARB class has become a standard option for managing hypertension and various cardiovascular and renal diseases.