Many ARBs are available in the United States, including Avapro (irbesartan), Cozaar (losartan), Benicar (olmesartan), Atacand (candesartan), Teveten (eprosartan), Micardis (telmisartan) and Diovan (valsartan).
How ARBs Help
ARBs help lower blood pressure by preventing a hormone (angiotensin II) from activating the body's rennin-angiotensin system. This system causes the narrowing of blood vessels and fluid retention that lead to high blood pressure. By reducing blood pressure and fluid retention, ARBs also help to control heart failure. ARBs are also effective in treating diabetes-related kidney damage and can possibly have a positive effect for people with type 2 diabetes.
How ARBs Do Not Help
ARBs do not slow the heartbeat or directly lower blood sugar levels.
ARBs Treat a Range of Cardiovascular Diseases and Related Conditions
ARBs were first approved by the Food and Drug Administration in the mid-1990s for treating hypertension. Since then, the use of ARBs has dramatically expanded. ARBs are now used to treat a range of cardiovascular diseases and related conditions, including heart failure and diabetic nephropathy. In fact, studies have shown that ARBs help control diabetic nephropathy, independent of their blood pressure-lowering effects.
The use and effectiveness of ARBs are similar to angiotensin-converting enzyme (ACE) inhibitors, which is another type of blood pressure medication.
Who Should Not Use ARBs
People should not use ARBs if they have very low blood pressure (hypotension) or if they have had an allergy or facial swelling from taking them. People with renal artery stenosis should not use ARBs. Also, pregnant women should not use ARBs.
People who have had significant kidney damage require adjusted dosing of ARBs.
Side Effects and Risks of ARBs
All blood pressure medications carry a risk of hypotension, with symptoms including lightheadedness, dizziness, nausea, sweatiness and possible loss of consciousness.
ARBs may cause high potassium levels in patients with kidney problems. ARBs do not cause a cough, which is a common side effect of ACE inhibitors.
Other "Off-Label" Uses for ARBs
In people with diabetic nephropathy, ARBs help prevent kidney disease from worsening. ARBs may also help prevent the onset of type 2 diabetes, although research evidence to support this is somewhat conflicting. In addition, ARBs may help prevent abnormal heart rhythms.
What Else Should Be Known About ARBs
People who develop a cough related to ACE inhibitors can often switch to ARBs with a good outcome.
As with any medication, it is important for healthcare providers to be informed of all current prescription and over-the-counter medications being taken by the patient on a daily or periodic basis. It is also important for patients to tell healthcare providers about any herbs and supplements before starting to take ARBs. Finally, the healthcare team should always be informed before any new medications are given to a patient.
LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Heather M. Ross, MS, APRN, NP, is an adult nurse practitioner specializing in cardiovascular care. She is a widely published author and lecturer in the fields of cardiac electrophysiology and heart failure. Ms. Ross lives in Paradise Valley, Ariz.
