Therapeutic role of angiotensin II receptor blockers in the treatment of heart failure

Angiotensin II type 1 receptor blockers (ARBs) are generally as effective as angiotensin-converting enzyme (ACE) inhibitors in patients with hypertension. However, inhibition of angiotensin is not achieved completely through the blocking effects of ACE inhibitors, and the possibility of a non-ACE pathway for generation of angiotensin II has important implications for treating cardiovascular disease. The selective quality of ARBs for the angiotensin II type 1 (AT(1)) receptor may confer an advantage. In a recently reported trial, the ARB valsartan substantially improved patients' New York Heart Association class, clinical signs and symptoms, and quality of life and provided morbidity and mortality benefits in selected patients. Valsartan was recently approved to treat heart failure in patients who cannot be maintained on an ACE inhibitor. As a class, ARBs are well tolerated and have a good safety profile.