Pharmacotherapy in congestive heart failure: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in congestive heart failure: do they differ in their renal effects in man?
Angiotensin-converting enzyme (ACE) inhibitors are used in the management of a wide range of cardiovascular conditions, including congestive heart failure (CHF). Although the experimental evidence in support of their use in CHF is incontrovertible, their pattern of usage has failed to keep pace with the research findings. One factor that has fueled the hesitancy to use ACE inhibitors in CHF has been the concern that renal function might worsen upon their receipt. Although the glomerular filtration rate may decline when ACE inhibitor or angiotension receptor blocker therapy is started in CHF, in most cases it is not a reason to discontinue therapy other than temporarily. Although ACE inhibitors and angiotensin receptor blockers may differ theoretically in their renal effects, published information to date has not shown such a difference. (c)2001 by CHF, Inc.
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Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298.