![]() ACE inhibitors lower blood pressure by blocking an enzyme early in the system so that less angiotensin, a chemical that narrows blood vessels, is produced, and blood vessels can remain wider and more relaxed. The findings are based on an analysis of eight electronic health record and insurance claim databases in the United States, Germany and South Korea that include almost 3 million patients taking a high blood pressure medication for the first time with no history of heart disease or stroke.īoth types of medicines work on the renin-angiotensin-aldosterone system, a group of related hormones that act together to regulate blood pressure. Currently, ACE inhibitors are prescribed more commonly than ARBs as a first-time blood pressure control medicine. While the class of blood pressure-lowering medicines called angiotensin-converting enzyme (ACE) inhibitors may be prescribed more commonly, angiotensin receptor blockers (ARBs) work just as well and may cause fewer side effects. ET Monday, July 26, 2021ĭALLAS, JPeople who are just beginning treatment for high blood pressure can benefit equally from two different classes of medicine – angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) – yet ARBs may be less likely to cause medication side effects, according to an analysis of real-world data published today in Hypertension, an American Heart Association journal. This information may assist clinicians in deciding which type of blood pressure-lowering medication to prescribe for patients diagnosed with hypertension for the first time.Įmbargoed until 4 a.m.51 possible side effects and safety concerns were examined: The patients taking ARBs were found to be significantly less likely to develop tissue swelling, cough, pancreas inflammation and bleeding in the digestive tract.In an analysis of almost 3 million patients taking a single high blood pressure medication for the first time, angiotensin receptor blockers (ARBs) were as good as angiotensin-converting enzyme (ACE) inhibitors at preventing cardiovascular events linked to hypertension, including heart attack, stroke and heart failure. ![]() Prescribing the least expensive ACE inhibitor in lower doses will lead to substantial cost savings, and possibly a reduction in dose-related adverse events. Due to incomplete reporting of the number of participants who dropped out of the trials due to adverse drug reactions, as well as the short duration of these trials, this review could not provide a good estimate of the harms associated with this class of drugs. This could mean that the drug companies are withholding unfavorable findings related to their drugs. Most of the trials in this review were funded by companies that make ACE inhibitors and serious adverse effects were not reported by the authors of many of these trials. ![]() No ACE inhibitor drug appears to be any better or worse than others in terms of blood pressure lowering ability. Most of the blood pressure lowering effect (about 70%) can be achieved with the lowest recommended dose of the drugs. There was an 8-point reduction in the upper number that signifies the systolic pressure and a 5-point reduction in the lower number that signifies the diastolic pressure. The blood pressure lowering effect was modest. The trials followed participants for approximately 6 weeks (though people are typically expected to take anti-hypertension drugs for the rest of their lives). These trials evaluated the blood pressure lowering ability of 14 different ACE inhibitors in 12 954 participants. We found 92 trials that randomly assigned participants to take either an ACE inhibitor or an inert substance (placebo). The available scientific literature was searched to find all the trials that had assessed this question. We asked how much this class of drugs lowers blood pressure and whether there is a difference between individual drugs within the class. This class includes drugs such as ramipril (brand name: Altace), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril) and quinapril (Accupril). The class of drugs called ACE inhibitors is commonly used for the treatment of elevated blood pressure.
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