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European Heart Journal 2004 25(5):357-358; doi:10.1016/j.ehj.2003.12.023
Copyright © 2004 by the European Society of Cardiology.
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Editorial

Angiotensin receptor blockers and heart failure: still CHARMing after VALIANT?

Karl Swedberga,* and John J.V McMurrayb

a Department of Medicine, Sahlgrenska University Hospital, Östra, SE 416 85 Göteborg, Sweden
b University of Glasgow, Glasgow, UK

* Correspondence to: Tel.: +46-313434000; fax: +46-312-589-33
E-mail address: karl.swedberg@hjl.gu.se

Received 19 December 2003; accepted 31 December 2003

The first 10% of the full text of this article appears below.

The effects of ACE-inhibitors have been documented extensively during the last 15 years. They offer wide benefits to patients with cardiovascular disease. Their effects are most prominent in patients with chronic activation of the renin–angiotensin–aldosterone system (RAAS) as are those of aldosterone receptor blockade. However, adverse effects are not uncommon. Antagonism of the actions of both angiotensin II and aldosterone can lead to deterioration in renal function. Notably, ACE-inhibitors also cause cough. Alternative approaches to inhibition of the RAAS are therefore important, particularly for patients who are intolerant of an ACE-inhibitor.

Angiotensin receptor blockers (ARBs) provide a unique pharmacological mechanism for inhibiting the RAS and they have demonstrated high tolerability in large trials. However, their efficacy has been uncertain, in comparison with ACE-inhibitors. . . . [Full Text of this Article]


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