From the Guidelines
Angiotensin II receptor blockers (ARBs) that are used to manage blood pressure include losartan, valsartan, candesartan, irbesartan, olmesartan, telmisartan, eprosartan, and azilsartan. These medications work by blocking the action of angiotensin II, a hormone that causes blood vessels to narrow, thereby allowing blood vessels to remain wider and lowering blood pressure 1. ARBs are commonly prescribed for hypertension, heart failure, diabetic nephropathy, and to reduce cardiovascular risk. They're often chosen as alternatives for patients who cannot tolerate ACE inhibitors due to side effects like cough. Most ARBs are taken once daily, with dosages varying by specific medication and patient needs.
Key Points
- Common side effects include dizziness, headache, and elevated potassium levels.
- ARBs should be used cautiously in pregnancy as they can cause fetal harm, particularly in the second and third trimesters.
- The use of ARBs is recommended in patients with heart failure with reduced LVEF, diabetes, or CKD unless contraindicated 1.
- ARBs have been shown to reduce mortality and HF hospitalizations in patients with HFrEF in large RCTs 1.
Medication Options
- Losartan
- Valsartan
- Candesartan
- Irbesartan
- Olmesartan
- Telmisartan
- Eprosartan
- Azilsartan It is recommended that ARBs be used as first-line treatments to lower BP, and that they be combined with other BP-lowering drugs, such as dihydropyridine CCBs or diuretics, for more effective BP control 1.
From the FDA Drug Label
Losartan Potassium Tablets is a prescription medicine called an angiotensin receptor blocker (ARB). Telmisartan tablets, USP are an angiotensin II receptor blocker (ARB) Telmisartan tablets, USP are an angiotensin II receptor blocker (ARB)
The ARB BP meds mentioned are:
From the Research
Angiotensin II Receptor Blockers (ARBs)
The following are some of the ARB blood pressure medications:
- Azilsartan 4
- Candesartan 5, 4, 6, 7, 8
- Eprosartan 5, 4
- Irbesartan 5, 4, 7, 8
- Losartan 5, 4, 6, 7, 8
- Olmesartan 4, 7
- Telmisartan 5, 4, 6, 7, 8
- Valsartan 5, 4, 6, 7, 8
Key Findings
Some key findings about these ARBs include:
- They have renal protective benefits in hypertensive type 2 diabetic patients with microalbuminuria or proteinuria 5
- The benefits of ARBs extend to normotensive diabetic patients as well 5
- Maximizing the ARB dose before adding additional therapies may be superior to adding another class of antihypertensive 5
- The duration of action of ARBs can vary, with some lasting over 24 hours 6
- The efficacy and safety of ARBs can vary, with some being more effective at lowering blood pressure and having fewer adverse events 7, 8