Issues in drug metabolism of major antihypertensive drugs: β-blockers, calcium channel antagonists and angiotensin receptor blockers

Several first-line antihypertensive drugs, including calcium channel blockers, beta-adrenergic blockers and angiotensin receptor blockers, undergo metabolism through different CYP isoforms. As a consequence of CYP-dependent metabolism, wide interindividual variability of plasma concentrations of ant...

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Detalhes bibliográficos
Autores: Höcht, Christian, Bertera, Facundo Martin, Mayer, Marcos Alejandro, Taira, Carlos Alberto
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2010
País:Argentina
Recursos:Consejo Nacional de Investigaciones Científicas y Técnicas
Repositório:CONICET Digital (CONICET)
Idioma:inglês
OAI Identifier:oai:ri.conicet.gov.ar:11336/113682
Acesso em linha:http://hdl.handle.net/11336/113682
Access Level:Acceso aberto
Palavra-chave:Angiotensin receptor blockers
Beta-blockers
Balcium channel blockers
CYP
https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
Descrição
Resumo:Several first-line antihypertensive drugs, including calcium channel blockers, beta-adrenergic blockers and angiotensin receptor blockers, undergo metabolism through different CYP isoforms. As a consequence of CYP-dependent metabolism, wide interindividual variability of plasma concentrations of antihypertensive drugs has been found in clinical practice compromising blood pressure lowering response and clinical outcomes. Several factors, including aging, hepatic impairment, drug interactions, conditions affecting hepatic blood supply and polymorphisms, contribute to changes in oral and systemic clearance affecting drug exposure during antihypertensive therapy and cardiovascular response. Considering that the degree of blood pressure reduction is related to antihypertensive drug plasma concentrations, a greater knowledge of the sources of pharmacokinetic variability of hepatically eliminated antihypertensive drugs and the applicability of an individualized approach in hypertension management by means of pharmacokinetic/pharmacodynamic modeling and pharmacogenetic testing could enhance blood pressure lowering response to pharmacological therapy. The aim of the present review is to discuss the relevance of drug metabolism in the treatment of hypertension.