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Angiotensin receptor blockers in heart failure after the ELITE II trial

Ronnie Willenheimer1

  • 1University Hospital Malmö, Malmö, Sweden. ronnie.willenheimer@medforsk.mas.lu.se

Current Controlled Trials in Cardiovascular Medicine
|November 21, 2001
PubMed

Insights

Angiotensin receptor blockers (ARBs) offer an alternative to ACE inhibitors for heart failure, showing similar efficacy but better tolerance. The ELITE II trial found no significant mortality benefit for ARBs compared to ACE inhibitors.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Angiotensin receptor blockers (ARBs) are a class of drugs targeting the angiotensin type 1 receptor.
  • They serve as an alternative treatment for heart failure compared to angiotensin-converting enzyme inhibitors (ACEi).

Purpose of the Study:

  • To evaluate the role of ARBs in heart failure management.
  • To compare the efficacy and tolerability of ARBs versus ACEi.

Main Methods:

  • Review of early studies and the ELITE II outcome trial.
  • Comparison of effects on hemodynamics, neurohormones, exercise capacity, mortality, and morbidity.

Main Results:

  • ARBs demonstrate better tolerability than ACEi.
  • ARBs show comparable effects on hemodynamics, neurohormones, and exercise capacity.
  • The ELITE II trial found no significant difference in mortality or morbidity between losartan (an ARB) and captopril (an ACEi).

Conclusions:

  • While ARBs are well-tolerated alternatives for heart failure, early suggestions of superior mortality benefits were not confirmed by major outcome trials like ELITE II.
  • The role of ARBs in heart failure treatment requires careful consideration of current evidence.
  • Further research may clarify the specific niches for ARBs in cardiovascular pharmacotherapy.

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