The role of angiotensin receptor blockers in the prevention of cardiovascular and renal disease: time for reassessment?

Angiotensin receptor blockers (ARB) have been recommended as a first option for the management of hypertension by guidelines, particularly in patients at high cardiovascular risk. The preference for ARB in these conditions is based on their neutral metabolic effects, and on direct cardiac and renal protective effects independent of the blood pressure-lowering effect (pleiotropic effects). Nonetheless, six large clinical trials designed to...