Drug Safety

, Volume 38, Issue 1, pp 33–54 | Cite as

The Comparative Efficacy and Safety of the Angiotensin Receptor Blockers in the Management of Hypertension and Other Cardiovascular Diseases

  • Hazel Mae A. Abraham
  • C. Michael White
  • William B. White
Review Article

Abstract

All national guidelines for the management of hypertension recommend angiotensin receptor blockers (ARBs) as an initial or add-on antihypertensive therapy. The eight available ARBs have variable clinical efficacy when used for control of hypertension. Additive blood pressure-lowering effects have been demonstrated when ARBs are combined with thiazide diuretics or dihydropyridine calcium channel blockers, augmenting hypertension control. Furthermore, therapeutic use of ARBs goes beyond their antihypertensive effects, with evidence-based benefits in heart failure and diabetic renal disease particularly among angiotensin-converting enzyme inhibitor-intolerant patients. On the other hand, combining renin–angiotensin system blocking agents, a formerly common practice among medical subspecialists focusing on the management of hypertension, has ceased, as there is not only no evidence of cardiovascular benefit but also modest evidence of harm, particularly with regard to renal dysfunction. ARBs are very well tolerated as monotherapy, as well as in combination with other antihypertensive medications, which improve adherence to therapy and have become a mainstay in the treatment of stage 1 and stage 2 hypertension.

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Hazel Mae A. Abraham
    • 1
  • C. Michael White
    • 2
  • William B. White
    • 1
  1. 1.Division of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center, University of Connecticut Health CenterUniversity of Connecticut School of MedicineFarmingtonUSA
  2. 2.University of Connecticut School of Pharmacy, Hartford HospitalStorrsUSA

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