When to recommend a combination of ACE-inhibitors and angiotensin receptor blockers

Czech version

Authors: J. Václavík
Authors‘ workplace: I. interní klinika – kardiologická LF UP a FN Olomouc
Published in: Kardiol Rev Int Med 2014, 16(6): 481-484
Category: Cardiology Review

Overview

ACE-inhibitors (ACE-I) and angiotensin receptor blockers (ARB) are frequently used in the treatment of arterial hypertension, coronary artery disease, heart failure, chronic kidney disease and diabetes mellitus. The combination of both drug classes in hypertension leads to a small additional blood pressure reduction, but does not lower the rate of cardiovascular events and has more complications, and therefore is now no longer recommended. Because of the increased number of complications, the combination of ACE-I and ARB is also not recommended in patients with coronary artery disease and chronic kidney disease. This combination is also being used less frequently in heart failure, but is still indicated in symptomatic patients with left ventricular dysfunction who do not tolerate mineralocorticoid receptor antagonists.

Keywords:
ACE-inhibitors – angiotensin receptor blockers – combination – hypertension – coronary artery disease – chronic kidney disease

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