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 telmisartan and enalapril on renoprotection in patients with mild to moderate chronic kidney disease.
BACKGROUND Blocking the renin-angiotensin system ( RAS ) with angiotensin receptor blockers or angiotensin-converting enzyme inhibitors protects against renal injury in patients with chronic kidney disease ( CKD ) . The aim of this study was to compare the chronic effects of telmisartan and enalapril on proteinuria , urinary liver-type fatty acid-binding protein ( L-FABP ) and endothelin (ET)-1 levels in patients with mild CKD . MATERIAL S AND METHODS Thirty CKD patients with mild to moderate renal insufficiency ( 20 men and 10 women ; mean age , 37 years ; estimated glomerular filtration rate ( eGFR ) > 60 mL min(-1 ) and blood pressure > 130/85 mmHg ) were included in the study . Patients were r and omly assigned to receive telmisartan at 80 mg day(-1 ) ( n = 15 ) or enalapril at 10 mg day(-1 ) ( n = 15 ) . We measured blood pressure , serum creatinine , eGFR , urinary protein , L-FABP and ET-1 before the start of treatment and 6 and 12 months after the start of treatment . RESULTS The blood pressure reduction rate was similar between the two groups . Urinary protein , L-FABP and ET-1 levels were significantly reduced in both groups 6 and 12 months ( P < 0.001 ) after treatment , but the reduction rates were more pronounced in patients receiving telmisartan than in those receiving enalapril ( P < 0.001 ) . Estimated glomerular filtration rate was increased similarly in both groups at 12 months . CONCLUSIONS The study results suggest that telmisartan results in a greater reduction of urinary markers than does enalapril and that this effect occurs by a mechanism independent of blood pressure reduction . It would be needed to investigate whether the differences may be distinct or not the same when other dosages are used
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 .