Angiotensin II is the main vasoactive hormone in the renin-angiotensin aldosterone system and plays a major role in the pathophysiology of hypertension, heart failure and other cardiovascular disorders. Angiotensin II also plays an important role in the pathogenesis of target organ damage and hypertrophy. The main physiological effects of angiotensin II such as vasoconstriction, aldosterone stimulation, regulation of water and salt homeostasis, and stimulation of cell growth are via type I receptors (AT1).
Candesartan cilexetil is a prodrug used orally. The product changes to its active form, namely candesartan when absorbed in the digestive tract by hydrolysis of esters. Candesartan cilexetil is an angiotensin II receptor antagonist, which is selective towards the AT 1 receptor, the bond is very strong and is released from the receptor slowly. Candesartan does not have an agonist effect.
Candesartan does not inhibit ACE which converts angiotensin I to angiotensin II and alters bradykinin. Does not affect ACE and there is no potentiating effect on bradykinin or P substance. In a controlled clinical trial comparing Candesartan cilexetil with ACE inhibitors, the frequency of cough was lower in patients receiving Candesartan cilexetil. Candesartan does not bind or inhibit other hormone receptors or ion channels that are known to be important in cardiovascular settings.