Table 2.

Role of RAAS inhibitors in heart failure.

RAAS Inhibitor	Observations
Angiotensin converting enzyme inhibitors (ACEI)
Captopril	Long-term administration was associated with an improvement in survival and reduced morbidity and mortality due to major cardiovascular events in patients with asymptomatic left ventricular (LV) dysfunction after myocardial infarction (MI) [82].
Enalapril	Increased exercise time and left ventricular ejection fraction (LVEF) [83].
Perindopril	Increased 6 min walk distance but did not decrease mortality [84]. After 1-year treatment reduced progressive LV remodeling but it was not associated with better clinical outcomes [85].
Ramipril	Administration to patients with clinical evidence of either transient or ongoing heart failure (HF) after MI resulted in a substantial reduction in premature death from all causes [86].
Trandolapril	Long-term treatment in patients with reduced LV function soon after MI significantly reduced the risk of overall mortality, mortality from cardiovascular causes, sudden death, and the development of severe HF [87].
Angiotensin II type 1 receptor blockers (ARBs)
Telmisartan	Telmisartan was well tolerated in patients unable to tolerate ACEI. Although the drug had no significant effect on hospitalizations for HF, it modestly reduced the risk of the composite outcome of cardiovascular death, MI, or stroke [88].
Candesartan	Slightly decreased hospitalizations but did not decrease mortality [89]. Reduced cardiovascular mortality and hospital admissions for worsening chronic HF. Patients with reduced ejection fraction were the most benefited [90].
Losartan	Reduced the rate of death or admission for HF in patients with HF, reduced LVEF, and intolerance to ACEI [91].
Valsartan	In patients with MI associated with HF and/or LV dysfunction, valsartan administration in the immediate post MI period demonstrated equal efficacy than captopril [92,93].
Aldosterone antagonists
Spironolactone	Prevented LV fibrosis and remodeling after MI [94]