angiotensin receptor blockers (ARB) in hypertension

Last reviewed 02/2023

  • the principal mechanism in which angiotensin II receptor inhibitors lower blood pressure is probably inhibition of angiotensin-mediated vasoconstriction

  • the antihypertensive efficacy of angiotensin II receptor inhibitors appears to be equal to that of atenolol or ACE inhibitors

  • angiotensin II receptor inhibitors and thiazide diuretics may be combined, resulting in additive hypotensive effects; an additive effect also occurs if angiotensin II receptor inhibitors are used with beta blockers

  • the combination of an ACE inhibitor and an angiotensin II receptor antagonist is not recommended (1)

  • angiotensin II receptor inhibitors have a gradual onset of action and adverse effects such as first dose hypotension are rare

  • the ACD strategy for hypertension management suggests an ACE inhibitor (or angiotensin II inhibitor) as first-line therapy for younger (non-black) patients

  • the VALUE trial compared the use of valsartan to amlodipine in the management of hypertension (see linked item)

Reference:

  1. Prescribers' Journal (1999);39 (1): 24-30.
  2. J Hum Hypertens. 2003 Feb;17(2):81-6.

Related pages:

angiotensin II receptor antagonists

Valsartan Anti-hypertensive Long-term Use Evaluation (VALUE)

ACD combination drug therapy in hypertensive patients