COMPARISON BETWEEN ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS AND ANGIOTENSIN-II ANTAGONISTS

The renin-angiotensin-aldosterone system (RAAS) plays an important rol e in blood pressure regulation and fluid and electrolyte homeostasis. Angiotensin converting enzyme inhibitors (ACEI) were the first of the RAAS blocking agents to be widely used in the treatment of hypertensio n and congestive heart failure. Ansotensin II receptor antagonists, an other class of pharmacological blockers of the RAAS, have more recentl y been shown to be safe and useful in hypertension and perhaps also in heart failure. This review deals with the similarities and difference s between these two classes of drugs with particular emphasis on the e ffects of the drugs on the heart, the blood vessels, the kidney (role of the drugs as nephroprotective), the brain, the hormonal profile and finally the potential adverse effects. The place of angiotensin II an tagonists in congestive heart failure remains to be more precisely def ined.