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 .
Comparison of the effects of quinapril and irbesartan on P-wave dispersion in hypertensive patients
Introduction P-wave dispersion ( PWD ) has been shown to be a non-invasive electrocardiographic predictor for development of atrial fibrillation ( AF ) . Thus , it may be possible to attenuate AF risk through improvement of PWD . In this study , we compared the effects of an angiotensin-converting enzyme ( ACE ) inhibitor , quinapril , and an angiotensin receptor blocker ( ARB ) , irbesartan , on PWD . Methods A total of 38 newly diagnosed hypertensive patients were enrolled in the study . The patients were r and omly assigned to receive treatment with either irbesartan ( 150–300 mg ) or quinapril ( 20–40 mg ) . P-wave duration s and PWD were measured at baseline and after 6 and 12 months of treatment . Echocardiographic examinations were performed at baseline and after 12 months of treatment . Results Both drugs significantly reduced blood pressure to a similar degree ( P<0.001 ) . Deceleration time ( both P<0.001 ) and isovolumetric relaxation time ( both P=0.007 ) were also significantly reduced , whereas there was no significant change in the early diastolic flow/atrial contraction signal ratio . Both irbesartan and quinapril significantly decreased maximum P-wave duration ( Pmax ) ( P<0.001 and P=0.002 , respectively ) and PWD ( from 68.0±22.1 to 41.0±25.1 msec for irbesartan , and from 70.5±20.4 to 46.6±13.3 msec for quinapril ; both P<0.001 ) . Baseline and follow-up blood pressure , heart rate , echocardiographic findings , and P-wave values were not significantly different between the irbesartan and quinapril groups . No patient developed AF during follow-up . There was no significant correlation between PWD and blood pressure or diastolic function parameters . Conclusion Antihypertensive treatment with either irbesartan or quinapril is associated with significant reductions in Pmax and PWD
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 .