SPECIAL PATIENT CONSIDERATIONS
The elderly and patients with renal or hepatic impairment
There are no specific considerations for the ARBs in the eld- erly or patients with renal or hepatic impairment. As with ACE inhibitors, acute renal failure may occur if these agents are given to patients with renal artery stenosis. In patients with mild to moderate hypertension who took part in the clinical trials, kid- ney function was not adversely affected; even in the presence of chronic renal insufficiency, ARBs are generally well tolerated, presumably because they are largely cleared in the bile (1).