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 .
Different actions of losartan and ramipril on adipose tissue activity and vascular remodeling biomarkers in hypertensive patients
We planned a r and omized , double blind clinical trial to evaluate whether an antihypertensive intervention at the proximal or distal level of the renin – angiotensin – aldosterone system could have different effects on a broad range of innovative cardiovascular risk biomarkers . A total of 288 hypertensive Caucasian patients ( 115 men and 113 women ) , aged ⩾18 years , were enrolled in this study . They were r and omized to take losartan 50 mg per day or ramipril 5 mg per day for 1 month and titrated up to 100 mg per day and 10 mg per day for 13 months , respectively . At baseline , 1 , 2 and 14 months after therapy initiation , we evaluated the following parameters : body weight , body mass index ( BMI ) , systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , fasting plasma glucose ( FPG ) , M-value , adiponectin ( ADN ) , resistin ( r ) , retinol binding protein-4 ( RBP-4 ) , visfatin , vaspin , high-sensitivity C-reactive protein ( Hs-CRP ) , matrix metalloproteinase-2 ( MMP-2 ) and matrix metalloproteinase-9 ( MMP-9 ) . No variation of body weight , BMI , FPG or vaspin was obtained with either treatment . We recorded a similar improvement in SBP , DBP and Hs-CRP with both treatments ; however , losartan also increased M-value , ADN and visfatin , whereas ramipril did not . Furthermore , losartan decreased r , RBP-4 , MMP-2 and MMP-9 , whereas ramipril did not have any effect on these parameters . In conclusion , we observed that short-term treatment with losartan improved several metabolic parameters ( M-value , ADN , RBP-4 , r and visfatin ) and decreased vascular remodeling biomarkers ( MMP-2 and MMP-9 )  in hypertensive subjects , whereas ramipril did not
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 .