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 .
Low doses of losartan and trandolapril improve arterial stiffness in hemodialysis patients.
BACKGROUND Hemodialysis patients have uremic dyslipidemia , represented by elevated serum intermediate-density lipoprotein cholesterol ( IDL-C ) levels , and an increased cardiovascular mortality rate . This study was performed to determine the low-dose effects of the angiotensin II receptor blocker losartan and the angiotensin-converting enzyme inhibitor tr and olapril on pulse wave velocity ( PWV ) , which predicts cardiovascular morbidity and mortality in hemodialysis patients . METHODS Serum lipid levels and PWV were monitored for 12 months in 64 hemodialysis patients who were administered low doses of losartan or tr and olapril or a placebo .  RESULTS At the start of the study , there were no differences in patient characteristics among the 3 groups . PWV tended to increase in the placebo group during the 12-month study period , but decreased significantly in the losartan and tr and olapril groups , and decreases in PWV were similar in the losartan and tr and olapril groups . There were no changes in blood pressure , hematocrit , erythropoietin dose , ankle-brachial index , serum lipid levels , serum 8-isoprostane levels , or serum C-reactive protein levels during the 12-month study period , but there was an increase in serum triglyceride levels in the losartan group and a decrease in serum IDL-C levels in the losartan and tr and olapril groups . CONCLUSION In hemodialysis patients , tr and olapril is as effective as losartan in decreasing PWV independent of its depressor effect and in suppressing elevated IDL-C levels . Long-term blockade of the renin-angiotensin system may have a beneficial effect on the acceleration of atherosclerosis and uremic dyslipidemia
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 .