Prior exposure to RAS-inhibiting medications was associated with an altered RAS profile and cardiovascular response to angiotensin-II treatment in patients with catecholamine-refractory vasodilatory shock.

ACE-inhibitor exposure was associated with greater sensitivity to angiotensin-II treatment, whereas ARB exposure was associated with a blunted response to angiotensin-II.

These findings may have clinical implications and indicate that these medications cannot be considered equivalent when initiating angiotensin-II treatment in vasodilatory shock.

Included n = 321 patients, of whom, 270 were ACEi and ARB-unexposed, 29 were ACEi-exposed and 22 ARB-exposed.

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