Angiotensin receptor blockers (ARB) in hypertension

• the principal mechanism in which angiotensin II receptor inhibitors lower blood pressure is probably inhibition of angiotensin-mediated vasoconstriction
  
  
• the antihypertensive efficacy of angiotensin II receptor inhibitors appears to be equal to that of atenolol or ACE inhibitors
  
  
• angiotensin II receptor inhibitors and thiazide diuretics may be combined, resulting in additive hypotensive effects; an additive effect also occurs if angiotensin II receptor inhibitors are used with beta blockers
  
  
• the combination of an ACE inhibitor and an angiotensin II receptor antagonist is not recommended (1)
  
  
• angiotensin II receptor inhibitors have a gradual onset of action and adverse effects such as first dose hypotension are rare
  
  
• the ACD strategy for hypertension management suggests an ACE inhibitor (or angiotensin II inhibitor) as first-line therapy for younger (non-black) patients
  
  
• the VALUE trial compared the use of valsartan to amlodipine in the management of hypertension (see linked item)

Reference:

1. Prescribers' Journal (1999);39 (1): 24-30.
2. J Hum Hypertens. 2003 Feb;17(2):81-6.