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Angiotensin Receptor Blockers (Angiotensin II Antagonists)

23 July 2007
ARBs are specific angiotensin II receptor antagonists with many properties similar to those of ACEIs. Unlike ACEIs, persistent dry cough is not a problem. As with ACEIs, they are contraindicated in pregnancy and bilateral renal artery stenoses, and should be used with caution in patients with renal impairment.

There is no difference in antihypertensive effect among the currently available ARBs.

Recent large outcome studies have demonstrated that ARBs are beneficial in the treatment of early and advanced type 2 diabetic nephropathy. A recent trial showed that an ARB, when compared to a beta-blocker, was able to prevent more cardiovascular morbidity and death in hypertensive patients with LVH6.

ARBsStarting DoseRecommended Maximum Dose
Candesartan8 mg16 mg
Irbesartan150 mg300 mg
Losartan 50 mg 100 mg
Telmisartan 40 mg 80 mg
Valsartan80 mg 160 mg

Table 16: ARBs commonly used for the treatment of hypertension in Malaysia.

Reference
Clinical Practice Guidelines on the Management of Hypertension


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