Amlodipine versus Angiotensin-receptor blockers for nonhypertension indications.

OBJECTIVE

To review the efficacy and safety data of amlodipine and the angiotensin-receptor blockers (ARBs), focusing on heart failure, angina, percutaneous coronary intervention (PCI), and renal protection.

DATA SOURCE: A MEDLINE search (1966-December 2001) was completed using amlodipine, angiotensin-receptor antagonist, losartan, valsartan, candesartan, and telmisartan as key words. English-language articles were identified and included.

STUDY SELECTION AND DATA EXTRACTION: All identified articles were evaluated. Articles representative of the subject matter of our review were included.

DATA SYNTHESIS: Amlodipine and the ARBs lower blood pressure to a similar extent. Amlodipine is an effective antianginal agent, whereas ARBs are not. However, amlodipine is not effective in the treatment of heart failure; ARBs may be useful in this setting. ARBs are also effective in preserving renal function and may provide some protection from restenosis in patients who have had a PCI. The ARBs may also be useful in preventing both diabetic and nondiabetic nephropathy.

CONCLUSIONS

Concomitant disease states should be considered when choosing between an ARB and amlodipine for the management of hypertension.