Angiotensin II Receptor Blockers

Angiotensin II Receptor Blockers (ARBs) block the effects of angiotensin II, which is useful in the treatment of heart failure and hypertension.  Angiotensin II stimulates the release of aldosterone, which results in sodium and water retention.  Angiotensin II itself is a potent vasoconstrictor, so by blocking angiotensin II receptors both cardiac afterload and preload are reduced. An advantage of ARBs compared to ACE inhibitors is that they do not cause an increase in bradykinin levels and do not have the same risk of angioedema and cough.

Class Drugs

• Azilsartan

• Candesartan

• Eprosartan

• Irbesartan

• Losartan

• Olmesartan

• Telmisartan

• Valsartan

Class Mechanism of Action

Blocks angiotensin II receptors, preventing activation caused by angiotensin II

Renin-Angiotensin-Aldosterone System - Sites of inhibition of various drug classes on the renin-angiotensin-aldosterone system

Class Applications

Hypertension

• ARBs prevent activation of angiotensin II, decreasing pre-load and afterload secondary to vasodilation (muscle arterioles and venous system), resulting in increased cardiac output.

• Decreases aldosterone levels, resulting in decreased sodium and water retention

Heart Failure

• Decreased pre-load and afterload secondary to vasodilation (muscle arterioles and venous system), resulting in increased cardiac output

• Decreases aldosterone levels, resulting in decreased sodium and water retention

• Improves patient survival in heart failure

Class Adverse Effects

• Decreased risk of angioedema and cough when compared with ACE inhibitors

• Teratogenic, contra-indicated in pregnancy

• Hyperkalemia

• Rash

• Altered taste

Drug Table

Drug Name	Application	Comments	Image
Azilsartan			"Arizona" "Sultan"
Candesartan			"Candy" "Sultan"
Eprosartan			"Epcot" "Sultan"
Irbesartan			"Ire" "Sultan"
Losartan			"Low" "Sultan"
Olmesartan			"Old" "Sultan"
Telmisartan			"Tell Me" "Sultan"
Valsartan			"Valspar Paint Can" "Sultan"