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Journal of Renin-Angiotensin-Aldosterone System
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*Heart Failure
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Interaction of -blockers and angiotensin receptor blockers/ACE inhibitors in heart failure

Jay N Cohn

Cardiovascular Division Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA, cohnx001{at}umn.edu

The renin-angiotensin-aldosterone system contributes to the progression of heart failure and its inhibition slows ventricular remodelling and favourably affects morbidity and mortality. -blockers exert a remarkably favourable effect on progression that may be mediated at least in part by renin inhibition. Although earlier trials suggested a possible adverse interaction when an angiotensin receptor blocker was added to an angiotensin-converting enzyme inhibitor and a -blocker, a recent study and newly analysed mechanistic data indicate that the triple combination provides modest additional inhibition of angiotensin that can further slow progression of disease.

Key Words: angiotensin • ACE inhibitors • -blockers • morbidity • mortality

Journal of Renin-Angiotensin-Aldosterone System, Vol. 4, No. 3, 137-139 (2003)
DOI: 10.3317/jraas.2003.021


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