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Journal of Renin-Angiotensin-Aldosterone System
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Review: The practical aspects of combination therapy with angiotensin receptor blockers and angiotensin-converting enzyme inhibitors

Domenic A Sica

Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Medical College of Virginia of Virginia Commonwealth University, USA, dsica@mail2. vcu.edu

Angiotensin-converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs) are widely prescribed for the management of hypertension. ACE inhibitors (ACE-I) and, more recently, ARBs have an established track record of success in the treatment of congestive heart failure (CHF), proteinuric renal disease and most recently the hypertensive patient with a high cardiac-risk profile. The individual success of each of these drug classes has fuelled speculation that given together the overall effect of both would exceed that of either given alone. This premise, although biologically plausible, has yet to be proven in a convincing enough fashion to support the routine use of these two drug classes in combination. Additional clarifying studies are needed to establish whether specific patient subsets exist that might benefit from such combination therapy.

Key Words: angiotensin-receptor blockers • ACE inhibitors • combination therapy • angiotensin II • congestive heart failure • hypertension • nephropathy

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Journal of Renin-Angiotensin-Aldosterone System, Vol. 3, No. 2, 66-71 (2002)
DOI: 10.3317/jraas.2002.020
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