Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in combination: theory and practice.
Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are commonly used to treat hypertension and/or a range of progressive end-organ diseases. The success of each of these drug classes in disease-state management is without dispute, and has led to speculation that given together the observed response would improve upon that observed with a member of each drug class individually given. Few studies are available, however, which carefully address the effect(s) of the combination of an angiotensin-converting enzyme inhibitor and an angiotensin receptor blocker. Review of available studies would seem not to strongly support combination therapy with an angiotensin-converting enzyme inhibitor and an angiotensin receptor blocker as preferred therapy in the broad base of general hypertensive patients with or without end-organ disease. Additional clarifying studies are needed to determine if specific patient subsets exist that might benefit from such combination therapy.
Sica
D A
DA
Department of Medicine, Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298-0160, USA. dsica@hsc.vcu.edu
Elliott
W J
WJ
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D011945:Receptors, Angiotensin / Q000627:therapeutic use*
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D011945:Receptors, Angiotensin