All concepts, explanations, trials, and studies have been
re-written in plain English and may contain errors. I am
not a doctor
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Source: Aust Fam Physician 2000 Jul;29(7):653-5
Title: Angiotensin receptor antagonists.
Authors: Wong W, Howes L.

INTRODUCTION:
We reviewed the drug action of various ARBs available
in Australia, including their side effects and potential
drug interactions.

FINDINGS:
ARBs are effective drugs for treating mild to moderate
high blood pressure. These drugs have so few side effects
they can be compare to placebo in that regard. These
drugs are of particular use to patients who are
intolerant of ACE inhibitors because of cough.

PMID: 10914449
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Source: Drugs 2000 May;59(5):1187-206
Title: Irbesartan: an updated review of its use in
       cardiovascular disorders.
Title: Markham A, Spencer CM, Jarvis B.

INTRODUCTION:
Irbesartan interrupts the renin-angiotensin system by
blocking angiotensin II subtype 1 receptors.

FINDINGS:
At 150 mg per day, irbesartan controlled diastolic
blood pressure in 56% of high blood pressure patients
according to several phase 3 studies, and 77% of
patients in a large phase 4 study. In other trials,
irbesartan was better for treating high blood pressure
than losartan and valsartan. It was just as good as
enalapril or atenolol. When hydrochlorothiazide is
added to irbesartan, a strong added effect is seen on
blood pressure.

The drug also reduces left heart enlargement and may
improve heart function in CHF patients. Irbesartan is
very well tolerated - as well as placebo, in fact.

CONCLUSIONS:
The current role of irbesartan as a treatment for heart
failure is unclear but it is very effective for
controlling high blood pressure.

PMID: 10852648
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Source: Tidsskr Nor Laegeforen 2000 Mar 10;120(7):817-21
Title: Use of angiotensin II receptor blockaders in
       heart failure.
Authors: Bonarjee VV, Dickstein K.

INTRODUCTION:
ACE inhibitors and diuretics are the first line of
treatment in heart failure patients. ACE inhibitors do
not completely block all angiotensin II production,
though. Also, some patients are intolerant to ACE
inhibitors because of side effects or low blood pressure.
ARBs - Angiotensin II receptor blockers - may be an
alternative.

FINDINGS:
Studies comparing the ARB losartan to placebo have
shown improved heart function, less hospitalisation and
mortality in CHF patients. Reduced complications and
mortality are also seen with losartan treatment, compared
captopril.

PMID: 10806906
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Source: Int J Clin Pract 2000 Jan-Feb;54(1):11-4, 16-8
Title: A study of the efficacy and safety of irbesartan
       in combination with conventional therapy,
       including ACE inhibitors, in heart failure.
       Irbesartan Heart Failure Group.
Authors: Tonkon M, Awan N, Niazi I, Hanley P, Baruch L,
         Wolf RA, Block AJ.

INTRODUCTION:
Because heart failure therapy with ACE inhibitors may
not be complete because of persistent angiotensin II
levels, we studied benefit of adding irbesartan - an ARB.

FINDINGS:
In this double-blind, placebo-controlled study, 109 class
2-3 patients having ejection fractions under 40% took
stable doses of ACE inhibitors and diuretics throughout
the study. Irbesartan dose was raised to 150 mg once daily
in all patients. Exercise tolerance time, EF, and clinical
status were measured at study start and after 12 weeks.

CONCLUSIONS:
Compared to placebo, irbesartan combined with standard
therapy - including ACE inhibitors - gave favourable
trends in exercise time and EF. It was well tolerated in
these patients with mild to moderate heart failure.

PMID: 10750252
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