Heart failure: is there a role for angiotensin II receptor blockers?
Angiotensin II receptor blockers (ARBs) directly inhibit the angiotensin II type 1 receptors, which suppresses the renin-angiotensin-aldosterone system (RAAS). Six ARBs are approved in Canada for the treatment of hypertension, none are yet approved for the treatment of heart failure (HF). Evidence comparing ARBs to angiotensin converting enzyme inhibitors (ACEIs) in HF is still limited. A recent meta-analysis of 17 clinical trials could not confirm that ARBs are superior to ACEIs in reducing either mortality or hospitalization in HF patients. ARBs may be used as an alternative in HF patients intolerant of ACEIs. A meta-analysis indicates that, compared to using an ACEI alone, adding an ARB to an ACEI carries the potential for additional benefits in terms of reduced hospitalization, but not mortality. However, the FDA determined there is currently insufficient evidence of such additional benefit when valsartan is combined to an ACEI in patients with HF.
Boucher
Michel
M
Ma
Johnny
J
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002170:Canada; D002986:Clinical Trials as Topic; D017277:Drug Approval; D016527:Drug Costs; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects; D014481:United States; D014486:United States Food and Drug Administration
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents