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 occur 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-receptormediated blood-pressureraising mechanism occurs in the kidney. There, the hormone aldosterone causes the body to retain more water, which increases blood volume and thus raises blood pressure.
How angiotensin II receptor blockers work
ARBs/sartans do not stop the production of angiotensin II; instead, they block angiotensin II at its site of action the subtype 1 angiotensin II receptor (hence AT1 blocker). Angiotensin II therefore cannot bind there. This reduces the vessel-narrowing and blood-pressureraising effects of angiotensin II. The kidney-related pathway via the hormone aldosterone is also interrupted.
Because the conversion of angiotensin I to angiotensin II is not prevented, bradykinin can be broken down normally. That is why the dry cough that often occurs with ACE inhibitor therapy happens much less frequently with ARBs.
Because the conversion of angiotensin I to angiotensin II is not prevented, bradykinin can be broken down normally. That is why the dry cough that often occurs with ACE inhibitor therapy happens much less frequently with ARBs.
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 comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands 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 in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
We hope you found the article helpful. For good blood pressure control, it's important to take your medications correctly. Our app BloodPressureDB will gladly remind you when to take them.
It also keeps track of your medication supply and notifies you in time when you're running low. This feature is fully available in the free version as well. Get the free app now.
