ARBs (Angiotensin II receptor blockers)

What they do

Angiotensin II receptor blockers (ARBs) block the actions of angiotensin II, a hormone naturally produced by your kidneys. By blocking the effect of angiotensin II, ARBs relax your blood vessels, which lowers your blood pressure. This means your heart doesn’t have to work so hard to squeeze your blood around your body.

ARBs have almost identical actions to ACE inhibitors. Because they are usually more expensive than ACE inhibitors, they are often reserved for patients who do not tolerate ACE inhibitors.

What are the expected benefits?

ARBs have been shown to reduce heart failure-related hospitalisations, prolong life, and improve exercise tolerance and quality of life.

Side effects

Side effects are extremely rare. Unlike ACE inhibitors, ARBs do not cause dry cough. But otherwise the side effects are the same for ARBs and ACE inhibitors. These include dizziness, which is common with any drug that lowers blood pressure. But your heart can function better at these lower pressures. Your blood pressure will be monitored regularly.

Like ACE inhibitors, ARBs can affect kidney function and increase potassium levels. Your doctor will monitor these levels regularly.

Top tips

Your doctor may advise you to take the first dose of your ARB before going to bed to try and prevent any dizziness. Dizziness is common with any drug that lowers blood pressure, but your heart can function better at these lower pressures.

If you do feel dizzy in the morning, try moving your feet back and forth about ten times before you stand up. Or, you may find it helpful to dangle your legs over the side of the bed before sitting up, and then sit at the side of the bed for a minute before standing. You should avoid standing up quickly, either from sitting or bending down, as this can make you feel dizzy. Take your time and allow your body to adjust.

Also known as:

  • Candesartan
    (Amias®, Atacand®)
  • Eprosartan
  • Irbesartan
    (Avapro®, Aprovel®, Avalide®)
  • Losartan
  • Olmesartan
    (Olmetec®, Benicar®)
  • Telmisartan
  • Valsartan
  • Combination products
    (Co Aprovel®, Cozaar-Comp®, Olmetec Plus®, Micardis Plus®, Co-Diovan®)


Animation explaining how angiotensin receptor inhibitors work in heart failure

Return to Heart failure medicines


ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

  • main types of heart failure
  • medicines used to treat heart failure
  • devices that may be appropriate
  • importance of rehabilitation
  • management by a multidisciplinary team
  • importance of self-care in managing your own condition

Learn more


A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.


In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.


and share your own views and experiences with other patients, families and caregivers. is a European Society of Cardiology website

The website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

Back to top