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 .
Aggressive antihypertensive strategies based on hydrochlorothiazide, candesartan or lisinopril decrease left ventricular mass and improve arterial compliance in patients with type II diabetes mellitus and hypertension
We investigated the effects of aggressive antihypertensive therapy based on hydrochlorothiazide , c and esartan or lisinopril on left ventricular mass ( LVM ) index and arterial stiffness in hypertensive type II diabetic individuals . Seventy hypertensive type II diabetic individuals were treated with three antihypertensive strategies in a r and omized , double-blind , double-dummy design . Blood pressure was titrated to levels below 130/85 mm Hg or a decrease in systolic pressure of 10 % with a diastolic pressure below 85 mm Hg . After titration , patients were treated for 12 months . Mean blood pressures were 157/93 , 151/94 and 149/93 mm Hg at baseline in the hydrochlorothiazide ( n=24 ) , c and esartan ( n=24 ) and lisinopril ( n=22 ) groups , and 135/80 , 135/82 and 131/80 mm Hg after titration . About 70 % reached target blood pressures , with the median use of three antihypertensive drugs . Left ventricular mass index and all estimates of arterial stiffness showed significant improvement after 12 months : that is , LVM index ( −11 g/m2 ; −8 % ) ; carotid distensibility coefficient ( DC ; + 2.8 × 10−3 kPa−1 ; + 27 % ) , compliance coefficient ( CC ; + 0.13 mm2/kPa ; + 21 % ) and elastic modulus ( −0.19 kPa ; −16 % ) ; femoral DC ( + 1.6 × 10−3 kPa−1 ; + 50 % ) and CC ( + 0.08 mm2/kPa ; + 26 % ) ; brachial DC ( + 2.1 × 10−3 kPa−1 ; + 39 % ) and CC ( + 0.03 mm2/kPa ; + 27 % ) and total systemic arterial compliance ( + 0.29 ml/mm Hg ; + 16 % ) . No differences in outcome variables between treatment groups were observed . Aggressive antihypertensive treatment , although difficult to achieve , result ed in substantial reductions of LVM index and arterial stiffness in relatively uncomplicated hypertensive type II diabetic individuals . Strategies based on renin – angiotensin system inhibitors were not clearly superior to conventional ( i.e. diuretic-based ) strategies
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 .