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Heart Failure and Angiotensin II Receptor Blockers

Angiotensin II receptor blockers (also called ARBs) block the effects of a substance called angiotensin II. Angiotensin II causes blood vessels to constrict, which can lead to high blood pressure. ARBs help dilate blood vessels to lower blood pressure, making it easier for the heart to pump blood. 

ARBs are often prescribed for patients who cannot tolerate an ACE inhibitor medication. 

Recommended Related to Heart Failure

Understanding Heart Failure -- Prevention

Drug therapy to lower blood pressure has been shown to reduce heart failure rates by 40%-60%. Reducing blockages in the coronary arteries with anti-cholesterol drugs has been shown to reduce heart failure rates by 30%. Early diagnosis and treatment of heart-valve abnormalities can prevent heart failure caused by chronic volume overload of the heart's left chamber.

Read the Understanding Heart Failure -- Prevention article > >

There are several different ARBs, including:

  • Atacand (candesartan)
  • Avapro (irbesartan)
  • Benicar (olmesartan)
  • Cozaar (losartan)
  • Diovan (valsartan)
  • Micardis (telmisartan)
  • Teveten (eprosartan)

 

Atacand and Diovan are approved for the treatment of patients with heart failure.

How Do I Take ARBs?

Most ARBs can be taken on an empty or full stomach. Ask your doctor or pharmacist for specific instructions. Follow the label directions on how often to take this medication. The number of doses you take each day, the time allowed between doses, and how long you need to take the medication will depend on the type of ARB prescribed, as well as your condition.

While taking this drug, have your blood pressure and kidney function tested regularly, as advised by your doctor or nurse.

Keep all appointments with your doctor and the laboratory so that your response to an ARB can be monitored.

Note: It may take many weeks for you to feel the full effects of the medication.

What Are the Side Effects of ARBs?

  • Dizziness, lightheadedness, or faintness upon rising: This side effect may be strongest after the first dose, especially if you have been taking a diuretic (water pill). Get up more slowly. Contact your doctor if these symptoms persist or are severe.
  • Diarrhea, muscle cramps or weakness, back or leg pain, insomnia (difficulty sleeping), sinusitis, or upper respiratory infection: Contact your doctor if these symptoms are persistent or severe.
  • Irregular heartbeat, or fast or slow heartbeat: Contact your doctor if these symptoms are persistent or severe.
  • Confusion: Contact your doctor right away.

If you become sick with severe vomiting or diarrhea, you may become dehydrated, which can lead to low blood pressure. Contact your doctor. Also contact your doctor if you have any other symptoms that cause concern.

Should I Avoid Certain Food or Medicine While Taking an ARB?

While taking an ARB, do not use salt substitutes; they contain potassium and this drug can cause the body to retain potassium. Learn how to read food labels to choose low-sodium and low-potassium foods. A dietitian can help you.

Over-the-counter nonsteroidal anti-inflammatory medicines (like ibuprofen or naproxen) and aspirin may cause the body to retain sodium and water, and decrease the effect of an ARB. Check with your health care provider before taking any anti-inflammatory medications.

Digoxin and warfarin may interfere with the effects of Micardis (telmisartan). If you are taking these drugs, tell your doctor before an ARB is prescribed.

Talk to your doctor before taking any new medication, including over-the-counter drugs, herbs, and supplements.

 

 

WebMD Medical Reference

Reviewed by James Beckerman, MD, FACC on September 20, 2014

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