TY - JOUR
T1 - A hard look at angiotensin receptor blockers in heart failure
AU - Gring, Christian N.
AU - Francis, Gary S.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2004/11/2
Y1 - 2004/11/2
N2 - Multiple trials over the past several years have examined indications for angiotensin receptor blockers (ARBs) in the treatment of left ventricular dysfunction, both acutely after myocardial infarction and in chronic heart failure. Yet despite these data, there is still confusion regarding the efficacy of ARBs as monotherapy in these patient populations, as well as the specific indications for combination ARB/angiotensin-converting enzyme (ACE) inhibitor therapy. We examine the key differences among the trials-including the ACE inhibitor dose, the ARB and its dose, blood pressure reduction, and patient populations-to present our perspective on ARB use, alone or in combination with ACE inhibitors, in patients with chronic heart failure and post-myocardial infarction left ventricular dysfunction. We conclude that ACE inhibitors remain the first-line therapy for left ventricular dysfunction. Angiotensin receptor blockers should be reserved for monotherapy in ACE intolerant patients and for combination therapy in symptomatic class II/III patients with chronic heart failure.
AB - Multiple trials over the past several years have examined indications for angiotensin receptor blockers (ARBs) in the treatment of left ventricular dysfunction, both acutely after myocardial infarction and in chronic heart failure. Yet despite these data, there is still confusion regarding the efficacy of ARBs as monotherapy in these patient populations, as well as the specific indications for combination ARB/angiotensin-converting enzyme (ACE) inhibitor therapy. We examine the key differences among the trials-including the ACE inhibitor dose, the ARB and its dose, blood pressure reduction, and patient populations-to present our perspective on ARB use, alone or in combination with ACE inhibitors, in patients with chronic heart failure and post-myocardial infarction left ventricular dysfunction. We conclude that ACE inhibitors remain the first-line therapy for left ventricular dysfunction. Angiotensin receptor blockers should be reserved for monotherapy in ACE intolerant patients and for combination therapy in symptomatic class II/III patients with chronic heart failure.
UR - http://www.scopus.com/inward/record.url?scp=7044269274&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=7044269274&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2004.07.044
DO - 10.1016/j.jacc.2004.07.044
M3 - Review article
C2 - 15519017
AN - SCOPUS:7044269274
SN - 0735-1097
VL - 44
SP - 1841
EP - 1846
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 9
ER -