The role of angiotensin receptor blockers in the management of chronic heart failure

Clinical and basic science research has repeatedly confirmed the importance of the reninangiotensin-aldosterone system in the pathophysiology of chron ic heart failure. Accordingly, blockade of this system by angiotensin-conve rting enzyme (ACE) inhibitors has assumed a central role in the treatment o f heart failure. Recently, angiotensin II receptor blockers (ARBs) have gai ned prominence as a possible substitute for ACE inhibitors in therapy for h eart failure. However, clinical data compiled on this use of ARBs have show n them to be useful only as alternative therapy in ACE inhibitor-intolerant patients. Continuing large-scale clinical investigations may lead to an ex pansion of their role in therapy for various cardiovascular diseases.