A hard look at angiotensin receptor blockers in heart failure

Christian N. Gring, Gary S. Francis

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations

Abstract

Multiple trials over the past several years have examined indications for angiotensin receptor blockers (ARBs) in the treatment of left ventricular dysfunction, both acutely after myocardial infarction and in chronic heart failure. Yet despite these data, there is still confusion regarding the efficacy of ARBs as monotherapy in these patient populations, as well as the specific indications for combination ARB/angiotensin-converting enzyme (ACE) inhibitor therapy. We examine the key differences among the trials-including the ACE inhibitor dose, the ARB and its dose, blood pressure reduction, and patient populations-to present our perspective on ARB use, alone or in combination with ACE inhibitors, in patients with chronic heart failure and post-myocardial infarction left ventricular dysfunction. We conclude that ACE inhibitors remain the first-line therapy for left ventricular dysfunction. Angiotensin receptor blockers should be reserved for monotherapy in ACE intolerant patients and for combination therapy in symptomatic class II/III patients with chronic heart failure.

Original languageEnglish (US)
Pages (from-to)1841-1846
Number of pages6
JournalJournal of the American College of Cardiology
Volume44
Issue number9
DOIs
StatePublished - Nov 2 2004

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