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Valsartan in chronic heart failure.
Ann Pharmacother. 2005 Mar; 39(3):460-9.AP

Abstract

OBJECTIVE

To evaluate the evidence for valsartan in the treatment of heart failure and determine its need for formulary inclusion.

DATA SOURCES

OVID and PubMed databases were searched (1983-June 2004) using the key words angiotensin-receptor blocker, heart failure, valsartan, Diovan, and angiotensin-converting enzyme inhibitor. Only English-language literature was selected.

STUDY SELECTION AND DATA EXTRACTION

Pharmacology and pharmacokinetic evaluations for valsartan were selected. Prospective, randomized clinical trials investigating the use of valsartan and other angiotensin-receptor blockers (ARBs) in chronic heart failure were evaluated.

DATA SYNTHESIS

Valsartan, a selective antagonist for angiotensin receptor subtype 1, is the first ARB to be approved for use in chronic heart failure. Clinical trial data support valsartan as an alternative to angiotensin-converting enzyme (ACE) inhibitors in ACE inhibitor-intolerant patients with chronic heart failure. Valsartan is generally well tolerated, with renal impairment, elevated serum creatinine and potassium levels, and dizziness being the most common adverse effects; consequently, patients experiencing those adverse events while taking ACE inhibitors are likely to experience them with valsartan. Although further study is needed, differences in effectiveness among races may exist with use of valsartan; however, at this time, valsartan is recommended as an alternative to ACE inhibitors regardless of race. Candesartan and losartan have been studied in similar settings. Candesartan's data support its use in heart failure; however, losartan's data have been less consistent.

CONCLUSIONS

Valsartan is a safe and effective alternative for heart failure patients intolerant of ACE inhibitors. Valsartan has not been shown to be safe and effective when used in combination with ACE inhibitors.

Authors+Show Affiliations

Department of Pharmacy: Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, PO Box 26901, Oklahoma City, OK 73190-5040, USA. toni-ripley@ouhsc.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15687480

Citation

Ripley, Toni L.. "Valsartan in Chronic Heart Failure." The Annals of Pharmacotherapy, vol. 39, no. 3, 2005, pp. 460-9.
Ripley TL. Valsartan in chronic heart failure. Ann Pharmacother. 2005;39(3):460-9.
Ripley, T. L. (2005). Valsartan in chronic heart failure. The Annals of Pharmacotherapy, 39(3), 460-9.
Ripley TL. Valsartan in Chronic Heart Failure. Ann Pharmacother. 2005;39(3):460-9. PubMed PMID: 15687480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Valsartan in chronic heart failure. A1 - Ripley,Toni L, Y1 - 2005/02/01/ PY - 2005/2/3/pubmed PY - 2005/5/7/medline PY - 2005/2/3/entrez SP - 460 EP - 9 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 39 IS - 3 N2 - OBJECTIVE: To evaluate the evidence for valsartan in the treatment of heart failure and determine its need for formulary inclusion. DATA SOURCES: OVID and PubMed databases were searched (1983-June 2004) using the key words angiotensin-receptor blocker, heart failure, valsartan, Diovan, and angiotensin-converting enzyme inhibitor. Only English-language literature was selected. STUDY SELECTION AND DATA EXTRACTION: Pharmacology and pharmacokinetic evaluations for valsartan were selected. Prospective, randomized clinical trials investigating the use of valsartan and other angiotensin-receptor blockers (ARBs) in chronic heart failure were evaluated. DATA SYNTHESIS: Valsartan, a selective antagonist for angiotensin receptor subtype 1, is the first ARB to be approved for use in chronic heart failure. Clinical trial data support valsartan as an alternative to angiotensin-converting enzyme (ACE) inhibitors in ACE inhibitor-intolerant patients with chronic heart failure. Valsartan is generally well tolerated, with renal impairment, elevated serum creatinine and potassium levels, and dizziness being the most common adverse effects; consequently, patients experiencing those adverse events while taking ACE inhibitors are likely to experience them with valsartan. Although further study is needed, differences in effectiveness among races may exist with use of valsartan; however, at this time, valsartan is recommended as an alternative to ACE inhibitors regardless of race. Candesartan and losartan have been studied in similar settings. Candesartan's data support its use in heart failure; however, losartan's data have been less consistent. CONCLUSIONS: Valsartan is a safe and effective alternative for heart failure patients intolerant of ACE inhibitors. Valsartan has not been shown to be safe and effective when used in combination with ACE inhibitors. SN - 1060-0280 UR - https://www.unboundmedicine.com/medline/citation/15687480/Valsartan_in_chronic_heart_failure_ L2 - http://journals.sagepub.com/doi/full/10.1345/aph.1E327?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -