Angiotensin II receptor blockers (ARBs) = Sartans
Angiotensin II receptor blockers (sartans, AT1 receptor antagonists or AT1 blockers) such as candesartan, irbesartan, losartan, olmesartan, telmisartan or valsartan are often used to treat high blood pressure when a dry cough or other side effects have occurred with an ACE inhibitor. They act in a similar way to ACE inhibitors but do not interfere with the breakdown of bradykinin. Unlike ACE inhibitors, ARBs do not block the conversion of angiotensin I to angiotensin II; instead, they work directly at the receptor. The receptors that angiotensin II can bind to are divided into two subtypes: AT1 and AT2 receptors. The blood-pressure-raising effect mainly comes from angiotensin II binding to an AT1 receptor. This causes the smooth muscle in the arterioles to contract, which raises blood pressure. A second AT1-receptor-mediated blood-pressure-raising mechanism occurs in the kidney. There, the hormone aldosterone causes less water to be excreted through the kidneys, which in turn increases blood volume and thus raises blood pressure.
How angiotensin II receptor blockers work
ARBs/sartans do not inhibit the formation of angiotensin II. Instead, they block subtype 1 of the angiotensin II receptors at the site where angiotensin II acts (the receptor), hence the name AT1 blockers. Angiotensin II therefore cannot bind there. This reduces its vasoconstricting and thus blood-pressure-raising effect. The regulatory pathway involving the kidneys and the hormone aldosterone is also interrupted.
Because the conversion of angiotensin I into angiotensin II is not prevented, bradykinin can be broken down without hindrance. As a result, the dry, irritating cough that frequently occurs during ACE inhibitor therapy is much less common.
Because the conversion of angiotensin I into angiotensin II is not prevented, bradykinin can be broken down without hindrance. As a result, the dry, irritating cough that frequently occurs during ACE inhibitor therapy is much less common.
Side effects of angiotensin II receptor blockers
Especially when you start taking them, there can be a strong drop in blood pressure, leading to dizziness, tiredness and headaches. ARBs can also cause elevated potassium levels in the blood. They are a good alternative to ACE inhibitors because the dry cough is much less common. Angioedema (skin swelling) also occurs less often than with ACE inhibitors. Because they tend to be more expensive, they are usually only prescribed when the ACE inhibitors used cause side effects for the patient.
Please also refer to the package leaflet of your medicine for the complete list of side effects.
Angiotensin II receptor blockers: active substances
Azilsartan, Candesartan, Eprosartan, Irbesartan, Losartan, Olmesartan, Telmisartan, Valsartan
Angiotensin II receptor blockers / Sartans: examples of active substances and approved medications
| Wirkstoff | Produkte |
| Azilsartan | Edarbi |
| Candesartan | Atacand, Blopresid Kombipräparat, Blopress, Camlostar Kombipräparat, CandeAmlo Kombipräparat, Candecor, Candegamma, Candesarplus Kombipräparat, Candesartan, Candesartancilexetil Kombipräparat, Caramlo Kombipräparat, Ratacand |
| Eprosartan | Eprosartan, Teveten |
| Irbesartan | Aprovel, Co-Irbenobel Kombipräparat, CoAprovel Kombipräparat, Ifirmasta, Irbecor comp Kombipräparat, Irbepress, Irbesartan, Karvea, Karvezide Kombipräparat |
| Losartan | Cozaar, Fortzaar Kombipräparat, Lorzaar, LosAmlo Kombipräparat, Losar, Losargamma, Losarplus Kombipräparat, Losartan |
| Olmesartan | Belsar, Olmecor, Olmesartan, Olmetec, Sevikar Kombipräparat, Vocado Kombipräparat |
| Telmisartan | Kinzalkomb Kombipräparat, Kinzalmono, Micardis, Pritor, Telmisartan, Tolucombi Kombipräparat, Tolura, Twynsta Kombipräparat |
| Valsartan | CoDiovan Kombipräparat, Copalia Kombipräparat, Cordinate, Cosamson Kombipräparat, Cotareg Kombipräparat, Dafiro Kombipräparat, Diovan, Exforge Kombipräparat, Provas, Valsacor, Valsargamma |
Sources
- https://leitlinien.dgk.org/files/28_2018_pocket_leitlinien_arterielle_hypertonie_aktualisiert.pdf
- https://flexikon.doccheck.com/de/AT1-Rezeptorantagonist?utm_source=www.doccheck.flexikon&utm_medium=web&utm_campaign=DC%2BSearch
- https://www.gelbe-liste.de/wirkstoffgruppen/at-1-antagonisten-sartane
- https://www.herzstiftung.de/infos-zu-herzerkrankungen/gerinnungshemmung-und-medikamente/sartane
- https://de.wikipedia.org/wiki/AT1-Antagonist
- http://www.pharmawiki.ch/wiki/index.php?wiki=Sartan
This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 12/2025).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
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