Angiotensin Receptor Blockers in Congestive Heart Failure: Evidence, Concerns, and Controversies

Heart failure results in neurohormonal activation of which the renin–angiotensin–aldosterone system (RAS) is the main mediator. Activation of this system leads to the production of angiotensin II (ATII), which leads to multiple adverse short-term and long-term effects, including hemodynamic dysfunct...

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Bibliographic Details
Published in:	Cardiology in review Vol. 13; no. 6; pp. 297 - 303
Main Authors:	Bhatia, Vishal, Bhatia, Ruchi, Mathew, Boban
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins, Inc 01-11-2005
Subjects:	Adrenergic beta-Antagonists - therapeutic use Angiotensin II Type 1 Receptor Blockers - administration & dosage Angiotensin II Type 1 Receptor Blockers - therapeutic use Angiotensin-Converting Enzyme Inhibitors - administration & dosage Angiotensin-Converting Enzyme Inhibitors - therapeutic use Benzimidazoles - therapeutic use Clinical Trials as Topic Dose-Response Relationship, Drug Drug Interactions Drug Therapy, Combination Heart Failure - drug therapy Humans Losartan - therapeutic use Mineralocorticoid Receptor Antagonists - therapeutic use Tetrazoles - therapeutic use Valine - analogs & derivatives Valine - therapeutic use Valsartan
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Summary:	Heart failure results in neurohormonal activation of which the renin–angiotensin–aldosterone system (RAS) is the main mediator. Activation of this system leads to the production of angiotensin II (ATII), which leads to multiple adverse short-term and long-term effects, including hemodynamic dysfunction, renal dysfunction, inflammation, and cardiac remodeling. Angiotensin-converting enzyme inhibitors (ACEIs) exert favorable effects in congestive heart failure (CHF) by inhibiting the production of ATII. It has been shown that ACEIs may not be able to suppress the production of ATII completely because there are RAS-independent mechanisms of ATII production. Hence, it was thought that angiotensin receptor blockers (ARBs) might be more useful in CHF because they directly block the ATII receptors. Many studies have been done to evaluate the role of ARBs in CHF. We reviewed these studies and have attempted to define the place and ARBs in the therapy for CHF.
ISSN:	1061-5377 1538-4683
DOI:	10.1097/01.crd.0000148236.34855.18