ACE and ARB equi-effective in HF?

[JamesL1585]

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Hey guys,

I remember when learning heart failure a fact I just told myself never to forget and that was "ACE inhibitors are almost equal to ARB's in efficacy in almost every disease state with the exception of Heart Failure..." I have been thinking this for at least two years because I heard that from somewhere... but today my preceptor asked me about it and I said that and she told me to find a reference for it and I checked all the major trials and majority of major trials show they are equivalent in HF... am I an idiot? or was there at least one trial that showed that ACE is the superior medication? If so do you know the trial?

Thanks in advance.

 

[pfaction]

They should be almost the same. If anything, ARBs may be somewhat better. IIRC, ACE blocks the effects of ATII at the AT2 receptor which is beneficial, whereas ARB blocks ATII at the AT1 only, which is better. Same pathway though.

 

[PumpkinSmasher]

They should be almost the same. If anything, ARBs may be somewhat better. IIRC, ACE blocks the effects of ATII at the AT2 receptor which is beneficial, whereas ARB blocks ATII at the AT1 only, which is better. Same pathway though.

Reciting mechanisms to the precptor will not get him a gold star. Primary literature is what OP is looking for....I think we all know the mechanistic differences...

 

[crazybob]

Reciting mechanisms to the precptor will not get him a gold star. Primary literature is what OP is looking for....I think we all know the mechanistic differences...

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