beta-blockers, angiotensin II, and ACE inhibitors in patients with heart failure

Blood concentrations of angiotensin II are often raised in patients with he art failure, despite treatment with angiotensin-converting-enzyme (ACE) inh ibitors. We compared concentrations of angiotensin II in two groups of matc hed patients, receiving ACE inhibitor therapy with or without concomitant a dministration of beta -blockers. Concentrations of angiotensin II were lowe r in individuals taking beta -blockers than in those who were not (geometri c mean 1.1 [95% CI 0.4-2.7] vs 15.5 [4.6-52.6] fmol/mL, 95% CI for differen ce 3-59). Our findings indicate that a reduction in angiotensin II concentr ations might contribute to the therapeutic benefits of beta -blockade in he art failure, especially in patients who simultaneously receive ACE inhibito r treatment.