Angiotensin II Type 1 Receptor Blockers
Overview
Overview
AT1 receptor blockers selectively prevent angiotensin II signalling at the AT1 receptor.
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Classification
Classification
AT1 receptor blockers selectively prevent angiotensin II signalling at the AT1 receptor.
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Mechanism of action
Mechanism of action
AT1 blockade reduces vasoconstriction, aldosterone release, sympathetic facilitation and sodium retention while leaving ACE-mediated bradykinin breakdown intact.
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Important members
Important members
Important members include losartan, valsartan, candesartan, irbesartan, telmisartan, olmesartan and azilsartan.
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Clinical uses
Clinical uses
Uses include hypertension and selected patients with heart failure or proteinuric kidney disease, guided by the indication and individual medicine evidence.
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Adverse effects
Adverse effects
Hyperkalaemia, hypotension and a rise in creatinine are central concerns; cough is much less characteristic than with ACE inhibition.
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Contraindications and precautions
Contraindications and precautions
Avoid in pregnancy. Do not routinely combine with an ACE inhibitor or direct renin inhibitor because dual blockade increases harm without routine benefit.
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References
References
- Patel P, Launico MV. Angiotensin II Receptor Blockers. NCBI Bookshelf. Updated 2025. SOURCE:NCBI:ARB:2025