Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Disclaimer
Right arrow Request Permissions
Google Scholar
Right arrow Articles by McMurray, J. J.V.
Right arrow Search for Related Content
PubMed
Right arrow Articles by McMurray, J. J.V.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The role of angiotensin II receptor blockers in the management of heart failure

John J.V. McMurray*

Department of Cardiology, Western Infirmary, Glasgow G11 6NT, UK

* Corresponding author. Tel: +44 141 211 1838; fax: +44 141 211 2252. E-mail address: j.mcmurray{at}bio.gla.ac.uk

Angiotensin-converting enzyme inhibitors (ACE-inhibitors) are first-line treatment for chronic heart failure (CHF) with a low left ventricular ejection fraction because they improve symptoms and reduce mortality and admission to hospital. Many CHF patients do not receive these agents because of intolerance. Like ACE-inhibitors, angiotensin II type 1 receptor blockers (ARBs) reduce the action of angiotensin II but achieve this effect by an alternative mechanism, thus they may be effective in patients who are intolerant to ACE-inhibitors. Recommendations concerning the efficacy of ARBs in CHF, in the 2001 European Society of Cardiology (ESC) guidelines, were appropriately cautious and their use has remained limited, reflecting uncertainties concerning their role in CHF. However, a number of large-scale clinical trials (including OPtimal Trial in Myocardial Infarction with the Angiotensin II Antagonist Losartan, VALsartan In Acute Myocardial iNfarcTion, and Candesartan in Heart failure: Assessment of Reduction in Mortality and Morbidity) have been completed since the publication of the 2001 guidelines that support the efficacy and safety of ARBs in CHF. Findings from these trials suggest that ARBs may improve outcomes across the CHF patient spectrum, including those with preserved or low ejection fractions, ACE-intolerant patients, in all cases as part of a polytherapeutic strategy. On the basis of these trial data, the revised 2005 ESC guidelines provide stronger recommendations for the use of ARBs in the management of CHF.

Key Words: Heart failure • Treatment • Angiotensin II receptor blockers


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.