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Journal of Renin-Angiotensin-Aldosterone System
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Angiotensin receptor blockers in heart failure

Jan Östergren

Karolinska Hospital, Stockholm, Sweden

John JV McMurray

University of Glasgow, Glasgow, Scotland, UK, j.mcmurray{at}bio.gla.ac.uk

Collectively, a series of large, prospective randomised outcome trials has now shown that angiotensin receptor blockers (ARBs) are of clinical value in a broad spectrum of patients with symptomatic heart failure, regardless of background therapy and ventricular function. There is a clear benefit of ARBs in patients unable to tolerate an angiotensin-converting enzyme (ACE) inhibitor and this benefit is of a similar magnitude to that obtained with an ACE inhibitor (ACE-I). Both Val-HeFT and, particularly, CHARM-Added, also show that symptoms, morbidity and mortality are further reduced if an ARB is added to an ACE-I. This benefit is not only statistically significant but clinically important. CHARM-Preserved showed that candesartan can reduce hospital admission for heart failure in patients with preserved systolic function though more definitive outcome data are needed in this group.

Key Words: heart failure • angiotensin • receptor antagonist • enzyme inhibitor • clinical trial

Journal of Renin-Angiotensin-Aldosterone System, Vol. 4, No. 3, 171-175 (2003)
DOI: 10.3317/jraas.2003.027
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