Blood Pressure Control Equally Good with ACEs and ARBs


Two common classes of blood pressure medications—angiotensin-conver ting enzyme (ACE)-inhibitors and angiotensin receptor blockers—might be equally effective in controlling blood pressure.

In a study by the Agency for Healthcare Research and Quality (AHRQ), ACE-inhibitors were slightly more likely than ARBs to cause a harmless but persistent dry cough. More research is needed to learn how the two types of agents differ in their longer-term benefits and risks and how they differ in decreasing the risk of heart attack, stroke, or death.

The study compared ACE-inhibitors and ARBs but not diuretics or beta blockers. ACE-inhibitors included benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (A cupril), ramipril (Altace), and trandolapril (Mavik). ARBs included candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan medoxomil (Benicar), telmisartan (Micardis), and valsartan (Diovan).

Among the conclusions:
•Dry cough was reported by about 1.7% of patients taking ACE-inhibitors and about 0.6% taking ARBs.
•Patients taking ACE-inhibitors were slightly more likely to withdraw from the studies.
•There were no apparent differences between the two classes of drugs in their impact on lipids or heart function, in managing or slowing diabetes, or in controlling renal disease.
•Future studies should include older patients and those from ethnic and racial minorities.

(Sources: Agency for Healthcare Quality and Research, November 1, 2007