ARTICLE

Angiotensin-converting enzyme (ACE) inhibitors are currently considered the mainstay of treatment for heart failure because of their effects in decreasing morbidity and mortality. However, up to 10 % of patients with heart failure may be intolerant of ACE inhibitor therapy because of intractable cough caused by these agents. The use of angiotensin II receptor blockers (ARBs) is now emerging for the management of heart failure in such patients. A literature review was undertaken to assess the clinical evidence available on the use of ARBs in the treatment of heart failure. Comparisons of these agents with ACE inhibitors in heart failure are growing but still limited. In particular, the effect of ARBs on morbidity and mortality is not clear. A recent meta-analysis of 17 clinical trials did not reveal any superiority of ARBs over ACE inhibitors in reducing either mortality or admission to hospital among patients with heart failure. On the basis of preliminary evidence, ARBs may be used in patients with heart failure who are intolerant of ACE inhibitors because of cough. Further research is required to more clearly define the role of these agents in the management of heart failure. Key words: angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, heart failur