Heart Beat

ACE, ARB duet questioned

An overproduction of stress hormones contributes to the symptoms of heart failure. ACE inhibitors and angiotensin-receptor blockers (ARBs) counteract the effects of these hormones in different ways. Does that mean taking an ACE inhibitor and an ARB offers double protection?

A report in the Oct. 8, 2007 Archives of Internal Medicine warns that the side effects of combining them might outweigh the benefits. In this analysis of four large trials, heart failure patients taking both drugs were more likely than those taking just an ACE inhibitor to develop kidney trouble, a high potassium level, or experience dizziness or falls due to low blood pressure. In the trials, taking an ACE inhibitor and an ARB reduced hospitalizations for heart failure but didn't improve survival. While not the final answer, this study is sure to spark more research on the benefits and risks of this increasingly popular drug combination.