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A review of the current evidence for the use of angiotensin-receptor blockers in chronic heart failure.
Int J Clin Pract. 2005 May; 59(5):571-8.IJ

Abstract

Angiotensin-converting enzyme (ACE) inhibitors have a central role in the management of heart failure, reflecting the contribution of the renin-angiotensin-aldosterone system to the pathophysiology of the condition. Angiotensin-receptor blockers (ARBs) bind specifically to the angiotensin type 1 receptor and may offer further benefits compared with ACE inhibitors. Candesartan, losartan and valsartan have all been evaluated in large clinical outcome trials in heart failure. They display marked differences in pharmacokinetics and receptor-binding properties that may contribute to observed differences in outcome. ELITE II found no significant difference in outcome with losartan as compared with captopril. In the Val-Heft trial, valsartan reduced heart failure hospitalisations when added to conventional therapy including an ACE inhibitor in most patients, but had no effect on mortality. The CHARM programme showed that candesartan reduced morbidity and mortality in heart failure with reduced systolic function, both when added to ACE inhibitor therapy or when used as an alternative in patients who are intolerant to ACE inhibitors. Moreover, the CHARM-preserved study suggested that candesartan is beneficial in patients with heart failure and preserved left-ventricular systolic function. A growing body of evidence show that ARBs are an important contribution to the pharmaceutical management of patients with heart failure.

Authors+Show Affiliations

Department of Cardiology, University of Lund, Malmö University Hospital, Malmö, Sweden. Leif.Erhardt@med.lu.se

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15857354

Citation

Erhardt, L R.. "A Review of the Current Evidence for the Use of Angiotensin-receptor Blockers in Chronic Heart Failure." International Journal of Clinical Practice, vol. 59, no. 5, 2005, pp. 571-8.
Erhardt LR. A review of the current evidence for the use of angiotensin-receptor blockers in chronic heart failure. Int J Clin Pract. 2005;59(5):571-8.
Erhardt, L. R. (2005). A review of the current evidence for the use of angiotensin-receptor blockers in chronic heart failure. International Journal of Clinical Practice, 59(5), 571-8.
Erhardt LR. A Review of the Current Evidence for the Use of Angiotensin-receptor Blockers in Chronic Heart Failure. Int J Clin Pract. 2005;59(5):571-8. PubMed PMID: 15857354.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of the current evidence for the use of angiotensin-receptor blockers in chronic heart failure. A1 - Erhardt,L R, PY - 2005/4/29/pubmed PY - 2005/10/27/medline PY - 2005/4/29/entrez SP - 571 EP - 8 JF - International journal of clinical practice JO - Int. J. Clin. Pract. VL - 59 IS - 5 N2 - Angiotensin-converting enzyme (ACE) inhibitors have a central role in the management of heart failure, reflecting the contribution of the renin-angiotensin-aldosterone system to the pathophysiology of the condition. Angiotensin-receptor blockers (ARBs) bind specifically to the angiotensin type 1 receptor and may offer further benefits compared with ACE inhibitors. Candesartan, losartan and valsartan have all been evaluated in large clinical outcome trials in heart failure. They display marked differences in pharmacokinetics and receptor-binding properties that may contribute to observed differences in outcome. ELITE II found no significant difference in outcome with losartan as compared with captopril. In the Val-Heft trial, valsartan reduced heart failure hospitalisations when added to conventional therapy including an ACE inhibitor in most patients, but had no effect on mortality. The CHARM programme showed that candesartan reduced morbidity and mortality in heart failure with reduced systolic function, both when added to ACE inhibitor therapy or when used as an alternative in patients who are intolerant to ACE inhibitors. Moreover, the CHARM-preserved study suggested that candesartan is beneficial in patients with heart failure and preserved left-ventricular systolic function. A growing body of evidence show that ARBs are an important contribution to the pharmaceutical management of patients with heart failure. SN - 1368-5031 UR - https://www.unboundmedicine.com/medline/citation/15857354/A_review_of_the_current_evidence_for_the_use_of_angiotensin_receptor_blockers_in_chronic_heart_failure_ L2 - https://doi.org/10.1111/j.1368-5031.2005.00513.x DB - PRIME DP - Unbound Medicine ER -