Heart Failure Reviews

, Volume 18, Issue 2, pp 135–140

Ace inhibitor therapy for heart failure in patients with impaired renal function: a review of the literature


DOI: 10.1007/s10741-011-9295-6

Cite this article as:
Valika, A.A. & Gheorghiade, M. Heart Fail Rev (2013) 18: 135. doi:10.1007/s10741-011-9295-6


Heart failure syndromes are often associated with multi-organ dysfunction, and concomitant liver, renal, and neurologic involvement is very common. Neuro-hormonal antagonism plays a key role in the management of this syndrome, and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are one of the cornerstones of therapy. Cardiorenal physiology is becoming more recognized in these patients with advanced heart failure, and the role of neuro-hormonal blockade in this setting is vaguely defined in the literature. Often, angiotensin-converting enzyme inhibitors are decreased or even withheld in these circumstances. The purpose of this article is to review the role and pathophysiology of ace inhibition and angiotensin receptor blockade in patients with acute and chronic heart failure syndromes and concomitant cardiorenal physiology.


Heart failure Cardiorenal Ace inhibitor Angiotensin receptor blocker Acute kidney disease Chronic kidney disease Worsening renal function 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.CardiologyNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Northwestern University Feinberg School of MedicineChicagoUSA

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