Beneficial Effects of Angiotensin Blockade in Heart Failure Due to Myocardial Infarction

ACE inhibitors – angiotensin II receptor antagonists: A useful combination therapy for ischemic heart disease

“…52,78 The beneficial action of RAS blockade on cardiac function in CHF are considered to be due to its ability to limit infarct size, enhance scar formation and reduce infarct expansion to decrease ventricular wall stress and prevent the ventricular remodeling after MI. 79 The complementary mechanisms of action of these 2 drug classes also create a strong rationale for combination therapy in high-risk patients because Ang II can be produced by non-ACE pathways that are unaffected by ACE inhibitors, and furthermore, ACE inhibitor treatment results in upregulation of the AT 1 receptor. Thus, combination therapy with ARBs and ACE inhibitors may be necessary to achieve more complete RAS blockade than can be achieved with either agent alone.…”