Abstract

Background: The efficacy of ACE inhibitor therapy is well-documented in the treatment of chronic heart failure and hypertension. As pharmacological mechanisms of ACE inhibition and angiotensin II AT1 receptor antagonists differ, an additional positive effect concerning left ventricular function and hypertension can be expected in combining ACE inhibitors with the AT1 receptor antagonist candesartan. Due to the fact that both drugs influence the RAA system, a change concerning the level of potassium and creatinine could be possible by using the combined therapy with candesartan and ACE inhibitors. Methods: 20 patients (69.8 ± 9.9 years) with advanced chronic heart failure (NYHA class III) or severe hypertension receiving long-term medication with diuretics and ACE inhibitors were additionally treated after clinical recompensation with candesartan (11.0 ± 3.9 mg/d). In a prospective study, we observed the course of potassium and creatinine, which were determined at baseline and after 45.5 ± 65.5 days of study medication treatment. Results: A slight but not significant increase of potassium level was observed under the additional candesartan treatment (initially mean 4.51 ± 0.45 mval/l versus under the study 4.71 ± 0.60 mval/l). The analysis of serum creatinine revealed no significant change during the observation period. Under the additional treatment with candesartan, a clinical improvement was reported. Conclusions: The additional treatment with the AT1 receptor antagonist candesartan, given to severe heart failure or hypertension patients who received diuretics, ACE inhibitors and mostly b-blockers, resulted in a beneficial effect by increasing cardiac performance or normalizing the blood pressure values. Under the combined therapy, a slight but not significant increase of serum potassium level was observed. Furthermore, no relevant change of serum creatinine was seen.

Author Details

Authors

• B. Gremmler¹
• K. Kisters²

Departments

• ¹ Department of Cardiology, Marienhospital Bottrop, and
• ² Department of Internal Medicine I, St. Anna-Hospital, Herne, Germany

Address

Dr. B. Gremmler
Marienhospital
Josef-Albers-Straße 70
46236 Bottrop, Germany
Email: [email protected]

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