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Candesartan is an angiotensin II type 1 (AT1) receptor blocker (ARB) developed by Takeda for the treatment of hypertension and chronic heart failure. It is administered as the prodrug candesartan cilexetil, which is rapidly and completely bioactivated by ester hydrolysis during absorption from the gastrointestinal tract to its active form, candesartan. Candesartan selectively blocks the binding of angiotensin II to the AT1 receptor in tissues such as vascular smooth muscle and the adrenal gland, thereby inhibiting the vasoconstrictive and aldosterone-secreting effects of the renin-angiotensin-aldosterone system (RAAS). In the context of chronic heart failure, candesartan is frequently evaluated and used as an add-on therapy to standard medical treatments (such as ACE inhibitors, beta-blockers, and diuretics) to reduce cardiovascular mortality and hospitalizations. The CandHeart trial specifically assessed the effects of candesartan as an add-on to standard therapy on brain natriuretic peptide (BNP) levels and cardiac function in patients with symptomatic heart failure.
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