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 .
Effect of quinapril or losartan alone and in combination on left ventricular systolic and diastolic functions in asymptomatic patients with diabetic autonomic neuropathy.
OBJECTIVE To investigate the effect of angiotensin converting enzyme inhibition ( ACE-I ) or angiotensin receptor blockade ( ARB ) , and their combination , on both diabetic autonomic neuropathy ( DAN ) and left ventricular ( LV ) diastolic dysfunction ( LVDD ) in asymptomatic patients with diabetes mellitus ( DM ) . MATERIAL S AND METHODS Sixty-two patients ( 34 women ) with long-term DM ( 24 with Type 1 ) and DAN , aged 51.7+/-13.9 years , free of coronary artery disease ( CAD ) or arterial hypertension ( HT ) at baseline , were studied for a 12-month period . Diagnosis of DAN was established if two or more of the st and ard cardiovascular reflex tests ( CRT ) were abnormal . Patients were r and omly allocated to quinapril ( 20 mg/day ) , losartan ( 100 mg/day ) , or quinapril plus losartan ( 20 mg/day+100 mg/day ) . LV systolic and diastolic function was assessed using radionuclide ventriculography ( RNV ) at baseline and after 12 months of treatment . RESULTS In all three treatment groups , abnormal CRT values were improved . In the quinapril group , the first third filling fraction ( 1/3FF , 48.9+/-17.8 % vs. 39.2+/-12.9 % at baseline , P=.005 ) was increased and the atrial contribution to ventricular filling ( 25.1+/-6.3 vs. 30.1+/-7.8 , P=.027 ) was reduced in the losartan group ; the peak filling rate ( PFR ) was improved ( 3.41+/-.62 vs. 3.11+/-.44 volumes/s , P=.05 ) , and in the combination group , the 1/3FF ( 39.4+/-11.8 % vs. 29.6+/-11.9 % , P=.018 ) was markedly increased , while the time to peak filling ( TPF ; 147+/-42 vs. 184+/-33 ms , P=.02 ) and the TPF/filling time ( TPF/FT ; 32.5+/-6.2 % vs. 38.2+/-5.7 % , P=.016 ) were reduced . CONCLUSIONS Early ACE-I or ARB improve both DAN and LVDD in asymptomatic patients with Type 1 or 2 DM , after 1 year of treatment . Their combination may be slightly better than monotherapies on DAN and LVDD . The clinical importance of these effects should be vali date d by larger studies
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 .