Understanding Angiotensin II Receptor Blockers (ARBs): Uses, Benefits, and Risks

Learn how ARBs help manage blood pressure, heart failure, and kidney disease, including benefits, side effects, and key safety information.

By Medha deb

Created on Sep 26, 2025

Learn how ARBs help manage blood pressure, heart failure, and kidney disease, including benefits, side effects, and key safety information.

Angiotensin II Receptor Blockers (ARBs): An In-Depth Guide

Angiotensin II receptor blockers (ARBs) are a class of medications widely used to treat high blood pressure, heart failure, and certain types of chronic kidney disease. This article explains how ARBs work, lists common types, discusses who may benefit, explores their benefits and risks, and answers key questions relevant to patients and caregivers.

Overview

High blood pressure, medically termed hypertension, is a major risk factor for cardiovascular complications such as heart attack, stroke, and kidney damage. According to the Centers for Disease Control and Prevention (CDC), approximately one in three American adults have high blood pressure, but just over half have it well-controlled. Prolonged hypertension can damage the heart and vascular system, increasing the risk of adverse health events.

Understanding the full spectrum of ARBs can be critical for patients and caregivers alike. Learn how understanding ARBs—uses, benefits, and risks—can empower your treatment decisions and maximize your health outcomes.

ARBs are primarily prescribed to:

Lower high blood pressure (hypertension)
Treat heart failure
Slow progression of chronic kidney disease (CKD), especially in people with diabetes
Protect against further heart damage after a heart attack

How ARBs Work

Angiotensin II is a hormone produced in the body that causes blood vessels to constrict, raising blood pressure. It also prompts the body to retain salt and water, further contributing to elevated blood pressure. ARBs work by blocking the action of angiotensin II at specific receptor sites (AT1 receptors) found in blood vessels, the heart, and kidneys.

By preventing angiotensin II from binding to AT1 receptors, ARBs help blood vessels stay relaxed and open.
This vasodilation reduces resistance and lowers blood pressure.
ARBs also counter salt and water retention, another contributor to high blood pressure.

If you're curious about how other medications compare, explore our comprehensive guide on ACE inhibitors and their role in heart and kidney health. This knowledge can help you make informed choices regarding your medication options.

ARBs differ from ACE inhibitors, another class of antihypertensive medications, which block the formation of angiotensin II itself. In contrast, ARBs selectively block angiotensin II’s effects at its receptor, often resulting in fewer side effects for some patients.

Common ARBs

Drugs classified as ARBs typically have names ending in “-sartan.” Some commonly prescribed ARBs include:

Azilsartan (Edarbi)
Candesartan (Atacand)
Eprosartan mesylate (Teveten)
Olmesartan (Benicar)
Irbesartan (Avapro)
Losartan potassium (Cozaar)
Telmisartan (Micardis)
Valsartan (Diovan)

ARBs are sometimes provided in combination with diuretics (e.g., hydrochlorothiazide) to further lower blood pressure. These include:

Considering the variety of treatment options? Check out our comprehensive guide to medications for heart failure, empowering you with knowledge about what choices are available and the benefits of each.

Hydrochlorothiazide-valsartan (Diovan HCT)
Hydrochlorothiazide-losartan (Hyzaar)

While all ARBs reduce blood pressure, certain ARBs are preferred for specific conditions. For example:

Valsartan: Often used for heart failure and after a heart attack.
Losartan: Preferred for heart failure, diabetic kidney damage, and stroke prevention.

Who Needs ARBs?

ARBs may be prescribed for individuals who:

Have high blood pressure that is not controlled by lifestyle changes or other medications.
Cannot tolerate ACE inhibitors due to side effects (such as persistent cough or angioedema).
Have heart failure requiring additional cardiovascular protection.
Have chronic kidney disease with proteinuria (excess protein in urine), particularly if related to diabetes.
Have recently experienced a heart attack, to prevent further damage and improve outcomes.

If you or a loved one falls into a risk category, discover our detailed overview on medication options for systolic heart failure, providing vital information to help navigate important decisions regarding treatment.

ARBs are suitable for adults and are sometimes used in younger patients under specific circumstances, based on physician recommendations.

Benefits of ARBs

Effective blood pressure reduction: ARBs reliably lower blood pressure by preventing vessel constriction and reducing salt and water retention.
Cardiovascular protection: Evidence supports their role in reducing the risk of heart failure progression and events after a heart attack.
Renal protection: ARBs slow the progression of kidney damage in patients with chronic kidney disease, notably among those with diabetes-induced nephropathy.
Stroke prevention: Some ARBs, such as losartan, are indicated for reducing stroke risk.

To enhance your understanding of how ARBs fit in the broader scope of treatment, read our comprehensive guide to heart failure medications. This resource can illuminate the options available and clarify any lingering questions.

In recent analyses of major clinical trials, ARBs have demonstrated continued safety without increasing the risk of death, heart attack, or stroke compared to other antihypertensive agents. Specific populations (e.g., women and non-smokers) may derive additional benefits.

Side Effects and Risks

Like all prescription medications, ARBs carry potential side effects and risks. Most patients tolerate ARBs well, but adverse effects can occur. Common side effects include:

Dizziness or feeling lightheaded, especially when first starting the medication
Increased potassium levels (hyperkalemia), which can be serious in rare cases
Fatigue or weakness
Headache

Uncommon and rare side effects:

Kidney function changes: ARBs can sometimes cause or worsen kidney problems, especially in patients with existing kidney disease.
Angioedema: Swelling of deeper layers of the skin (rare; more common with ACE inhibitors).
Other allergic reactions: Rash or itching (rare).

Contrary to some older studies suggesting a possible increase in heart attack risk with ARBs, recent meta-analyses have confirmed that ARBs do not increase the risk of major cardiovascular events or overall mortality. The slight differences in safety profiles between ARBs and ACE inhibitors often make ARBs a suitable alternative for patients who experience side effects from ACE inhibitors.

Relationship to Cancer and Other Conditions

Some studies have explored a possible link between ARBs and cancer risk. However, current evidence does not demonstrate a consistent or significant increase in cancer risk among patients using ARBs.

Long-term studies and systematic reviews have concluded that ARBs are safe for regular use and do not increase the incidence of major cancers.
Regular monitoring and periodic assessment are advisable for all patients on long-term antihypertensive therapy.

Note: ARBs are not recommended during pregnancy as they can harm the developing fetus.

Comparing ARBs with Other Hypertension Drugs

Feature	ARBs	ACE Inhibitors	Diuretics	Calcium Channel Blockers
Mechanism	Block angiotensin II receptors	Block angiotensin II formation	Promote salt & water excretion	Relax blood vessel muscles
Common Side Effects	Dizziness, high potassium	Cough, angioedema, high potassium	Frequent urination, low potassium	Swelling, flushing, palpitations
Use if intolerant to ACE inhibitors	Yes	No	Yes	Yes
Kidney protection	High	High	Moderate	Low
Pregnancy safety	No	No	Yes (some types)	Yes (some types)

Tips for Safe Use of ARBs

Take your medication exactly as prescribed by your healthcare provider.
Attend regular medical appointments to monitor blood pressure, kidney function, and electrolyte levels.
Report any new symptoms, such as swelling, persistent cough, or muscle weakness.
Inform your doctor of other medications and supplements you take to avoid dangerous interactions.
Do not discontinue ARBs abruptly without medical advice, as this could cause blood pressure spikes.

Frequently Asked Questions (FAQs)

Q: What makes ARBs different from ACE inhibitors?

A: ARBs block angiotensin II’s action at its receptor, while ACE inhibitors prevent the hormone’s formation. Both lower blood pressure but ARBs are less likely to cause persistent cough or angioedema.

Q: Are ARBs safe for long-term use?

A: Yes, extensive clinical research shows ARBs are safe for long-term use in managing hypertension, heart failure, and CKD, with no increased risk of heart attack, stroke, or death.

Q: Can ARBs be taken with other blood pressure medications?

A: ARBs can be combined with other antihypertensive agents, such as diuretics or calcium channel blockers, for better blood pressure control. Your doctor will determine the best combination for your condition.

Q: Are ARBs suitable for pregnant women?

A: No, ARBs are contraindicated in pregnancy due to potential harm to the fetus. Alternative medications should be used if blood pressure treatment is necessary during pregnancy.

Q: Will I need regular blood tests while on ARBs?

A: Yes, healthcare providers typically monitor kidney function and potassium levels periodically to ensure safe and effective therapy, especially if you have underlying kidney disease.

Key Takeaways

ARBs are vital medications for managing high blood pressure, heart failure, and kidney disease.
They work by blocking the harmful effects of angiotensin II, resulting in lowered blood pressure and organ protection.
Most patients tolerate ARBs well, but regular monitoring and medical supervision are essential for optimal outcomes.

Resources for Patients

Blood pressure log – Track readings at home to share with your healthcare provider.
Medication guide – Review your prescribed medications and clarify dosing with your pharmacist.
Dietary advice – Limit salt intake and maintain a healthy diet to support blood pressure control.
Physical activity – Regular exercise can enhance ARB effectiveness and overall heart health.

Consult Your Healthcare Provider

If you have questions or concerns about ARBs, potential side effects, or their role in your treatment plan, consult your healthcare provider for individualized guidance. Managing blood pressure and cardiovascular health is a lifelong process, but ARBs can be an effective and safe cornerstone for many patients.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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