Our analyses found no evidence of a difference in total mortality or cardiovascular outcomes for ARBs as compared with ACE inhibitors , while ARBs caused slightly fewer WDAEs than ACE inhibitors .
Although ACE inhibitors have shown efficacy in these outcomes over placebo , our results can not be used to extrapolate the same conclusion for ARBs directly , which have not been studied in placebo-controlled trials for hypertension .
BACKGROUND Angiotensin converting enzyme inhibitors ( ACE inhibitors ) and angiotensin receptor blockers ( ARBs ) are widely prescribed for primary hypertension ( systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg ) .
However , while ACE inhibitors have been shown to reduce mortality and morbidity in placebo-controlled trials , ARBs have not .
Therefore , a comparison of the efficacies of these two drug classes in primary hypertension for preventing total mortality and cardiovascular events is important .
OBJECTIVES To compare the effects of ACE inhibitors and ARBs on total mortality and cardiovascular events , and their rates of withdrawals due to adverse effects ( WDAEs ) , in people with primary hypertension .
Effects of valsartan or ramipril addition to amlodipine/hydrochlorothiazide combination on left ventricular mass in diabetic hypertensive patients with left ventricular hypertrophy
Objective : The objective of this study was to compare valsartan or ramipril addition to amlodipine + hydrochlorothiazide ( HCTZ ) on blood pressure ( BP ) and left ventricular hypertrophy ( LVH ) in hypertensive diabetic patients with LVH . Research design and methods : 293 patients were treated with  amlodipine 10 mg + HCTZ 12.5 combination and then r and omized to receive valsartan 160 mg or ramipril 5 mg , in addition to the previous therapy , for 1 year . Main outcome measures : Clinic BP was measured every month ; echocardiographic assessment s were performed at the end of the placebo period , both before the r and omization and after 1-year of triple combination therapy . Results : Both triple regimens similarly reduced SBP/DBP values ( -13.5/10.9 mm Hg in the valsartan group and -13.4/10.4 mm Hg in the ramipril group ) . Triple combination including valsartan better reduced LVMI ( -20.1 % , p < 0.001 ) , interventricular septal thickness ( IVST ) ( -20.3 % , p < 0.001 ) and left ventricular posterior wall thickness ( PWT ) ( -16.3 % , p < 0.001 ) , compared with triple combination including ramipril ( -14 % , p < 0.01 ; -16.2 % , p < 0.001 and -9 % , p < 0.01 , respectively ) ; the difference between treatments being statistically significant ( p < 0.05 ) . Triple combination with valsartan gave a greater increase of E/A ratio ( p < 0.05 between groups ) . Conclusions : Valsartan addition to dual therapy with amlodipine + HCTZ was more effective than ramipril addition in reducing LVH
Our analyses found no evidence of a difference in total mortality or cardiovascular outcomes for ARBs as compared with ACE inhibitors , while ARBs caused slightly fewer WDAEs than ACE inhibitors .
Although ACE inhibitors have shown efficacy in these outcomes over placebo , our results can not be used to extrapolate the same conclusion for ARBs directly , which have not been studied in placebo-controlled trials for hypertension .
BACKGROUND Angiotensin converting enzyme inhibitors ( ACE inhibitors ) and angiotensin receptor blockers ( ARBs ) are widely prescribed for primary hypertension ( systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg ) .
However , while ACE inhibitors have been shown to reduce mortality and morbidity in placebo-controlled trials , ARBs have not .
Therefore , a comparison of the efficacies of these two drug classes in primary hypertension for preventing total mortality and cardiovascular events is important .
OBJECTIVES To compare the effects of ACE inhibitors and ARBs on total mortality and cardiovascular events , and their rates of withdrawals due to adverse effects ( WDAEs ) , in people with primary hypertension .