Ikeda Yasuhiro, Yamada Michio, Matsuzaki Masunori
Department of Bioregulation, Division of Cardiovascular Medicine, Yamaguchi University School of Medicine.
Nihon Rinsho. 2002 Oct;60(10):2028-33.
Angiotensin receptor blocker(ARB) is expected to be a substitute of ACE inhibitor for ACE inhibitor(ACEi) incompetent patient or an additive drug for the treatment of severe heart failure. Two large mega-trials(ELITE II & Val-HEFT) have been reported so far and one large trial(CHARM) is ongoing. In ELITE II study, there was no additional beneficial effects of ARB compared to ACEi(captopril). On the other hand, additive ARB may be beneficial for most of patients with heart failure, according to the Val-Heft trial. However, some adverse effects of ARB by the combinatory use with ACEi and beta-blocker should be taken into careful consideration. Ongoing CHARM trial may answer if ARB is ultimately useful for the treatment of heart failure.
血管紧张素受体阻滞剂（ARB）有望成为不能耐受血管紧张素转换酶抑制剂（ACEi）患者的替代药物，或用于治疗重度心力衰竭的附加药物。目前已报道了两项大型试验（ELITE II和Val-HEFT），还有一项大型试验（CHARM）正在进行中。在ELITE II研究中，与ACEi（卡托普利）相比，ARB没有额外的有益作用。另一方面，根据Val-Heft试验，附加使用ARB可能对大多数心力衰竭患者有益。然而，应仔细考虑ARB与ACEi和β受体阻滞剂联合使用时的一些不良反应。正在进行的CHARM试验可能会回答ARB最终是否对心力衰竭治疗有用。
