Role of angiotensin receptor blockers in patients with left ventricular dysfunction: lessons from CHARM and VALIANT

The role of angiotensin receptor blockers (ARBs) in patients with left ventricular dysfunction has changed after the VALIANT and CHARM trials. CHARM proved that candesartan is a good alternative for patients with chronic heart failure who cannot tolerate ACE-inhibitors. Moreover, VALIANT demonstrated non-inferiority of valsartan compared to captopril in patients after an acute myocardial infarction. The add-on effects of an ARB on top of an ACE-inhibitor are somewhat less pronounced, although a reduction in the number of hospitalizations for heart failure seems a consistent finding.