Congestive Heart Failure (Part 03) = Mechanism of Action for Angiotensin & Beta Adrenergic Blocker

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These drugs have very similar effects to angiotensin-converting enzyme (ACE) inhibitors and are used for the same indications (hypertension, heart failure, post-myocardial infarction). Their mechanism of action, however, is very different from ACE inhibitors, which inhibit the formation of angiotensin II. ARBs are receptor antagonists that block type 1 angiotensin II (AT1) receptors on blood vessels and other tissues such as the heart.

ARBs have the following actions, which are very similar to ACE inhibitors:

(1) Dilate arteries and veins and thereby reduce arterial pressure and preload and afterload on the heart.
(2) Down-regulate sympathetic adrenergic activity by blocking the effects of angiotensin II on sympathetic nerve release and reuptake of norepinephrine.
(3) Promote renal excretion of sodium and water (natriuretic and diuretic effects) by blocking the effects of angiotensin II in the kidney and by blocking angiotensin II stimulation of aldosterone secretion.
(4) Inhibit cardiac and vascular remodelling associated with chronic hypertension, heart failure, and myocardial infarction.

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