COMPARATIVE EFFICACY OF ACE INHIBITORS VS. ARBS IN THE MANAGEMENT OF HYPERTENSION AND HEART FAILURE
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.1001Keywords:
Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, Hypertension, Heart Failure, Comparative StudyAbstract
Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARBs) are two classes of medications widely used to treat hypertension and heart failure. Objective: The study aims to find the comparative efficacy of ACE inhibitors vs. ARBs in managing hypertension and heart failure. Methodology: This comparative observational study was conducted at Mirpur University of Science and Technology MUST, Azad Kashmir, from January 2023 to December 2023. The study included 85 patients diagnosed with either hypertension, heart failure, or both. Baseline characteristics such as age, gender, and comorbidities were recorded for each patient to ensure a balanced comparison between those treated with ACE inhibitors and those treated with ARBs. Both groups showed significant reductions in blood pressure, with ACE Inhibitors leading to a mean systolic decrease of 15.2 mm Hg and a diastolic reduction of 9.8 mm Hg, compared to 14.7 mm Hg and 9.4 mm Hg, respectively, for ARBs. However, the differences between the groups were not statistically significant (p > 0.05).Results: Data were collected from 85 patients. The average age was approximately 65 years in both groups. Gender distribution was nearly equal, with males comprising 48% of the ACE Inhibitors group and 49% of the ARBs group, while females comprised 52% and 51%, respectively. Diabetes was slightly higher in the ACE Inhibitors group (36%) than in the ARB group (33%). Conclusion: Both ACE inhibitors and ARBs are equally effective in managing hypertension and heart failure, with similar efficacy in reducing blood pressure and improving heart failure symptoms.
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Peresuodei TS, Gill A, Orji C, Reghefaoui M, Palacios MSS, Nath TS. A comparative study of the safety and efficacy between angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the management of hypertension: a systematic review. Cureus. 2024;16(2).
Ad B, P O-S. Valsartan: long term efficacy and tolerability compared to lisinopril in elderly patients with essential hypertension. Clinical and Experimental Hypertension. 1997;19(8):1263-85.
Fogari R, Ambrosoli S, Corradi L, Degli Esposti E, Mos L, Nami R, et al. 24-Hour blood pressure control by once-daily administration of irbesartan assessed by ambulatory blood pressure monitoring. Journal of hypertension. 1997;15(12):1511-8.
Flack JM, Saunders E, Gradman A, Kraus WE, Lester FM, Pratt JH, et al. Antihypertensive efficacy and safety of losartan alone and in combination with hydrochlorothiazide in adult African Americans with mild to moderate hypertension. Clinical therapeutics. 2001;23(8):1193-208.
Salvador GL, Marmentini VM, Cosmo WR, Junior EL. Angiotensin-converting enzyme inhibitors reduce mortality compared to angiotensin receptor blockers: Systematic review and meta-analysis. European Journal of Preventive Cardiology. 2017;24(18):1914-24.
Strauss MH, Hall AS. Angiotensin receptor blockers do not reduce risk of myocardial infarction, cardiovascular death, or total mortality: further evidence for the ARB-MI paradox. Circulation. 2017;135(22):2088-90.
Chen R, Suchard MA, Krumholz HM, Schuemie MJ, Shea S, Duke J, et al. Comparative first-line effectiveness and safety of ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers: a multinational cohort study. Hypertension. 2021;78(3):591-603.
Ko D, Azizi P, Koh M, Chong A, Austin P, Stukel T, et al. Comparative effectiveness of ACE inhibitors and angiotensin receptor blockers in patients with prior myocardial infarction. Open Heart. 2019;6(1):e001010.
Bangalore S, Fakheri R, Toklu B, Ogedegbe G, Weintraub H, Messerli FH, editors. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in patients without heart failure? Insights from 254,301 patients from randomized trials. Mayo Clinic Proceedings; 2016: Elsevier.
Messerli FH, Bangalore S. Angiotensin receptor blockers reduce cardiovascular events, including the risk of myocardial infarction. Circulation. 2017;135(22):2085-7.
Hoang V, Alam M, Addison D, Macedo F, Virani S, Birnbaum Y. Efficacy of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in coronary artery disease without heart failure in the modern statin era: a meta-analysis of randomized-controlled trials. Cardiovascular drugs and therapy. 2016;30:189-98.
Tan NY, Sangaralingham LR, Sangaralingham SJ, Yao X, Shah ND, Dunlay SM. Comparative effectiveness of sacubitril-valsartan versus ACE/ARB therapy in heart failure with reduced ejection fraction. JACC: Heart Failure. 2020;8(1):43-54.
Greene SJ, Butler J, Hellkamp AS, Spertus JA, Vaduganathan M, Devore AD, et al. Comparative effectiveness of dosing of medical therapy for heart failure: from the CHAMP-HF registry. Journal of Cardiac Failure. 2022;28(3):370-84.
Chen JS, Pei Y, Li Ce, Li Yn, Wang Qy, Yu J. Comparative efficacy of different types of antihypertensive drugs in reversing left ventricular hypertrophy as determined with echocardiography in hypertensive patients: A network meta‐analysis of randomized controlled trials. The Journal of Clinical Hypertension. 2020;22(12):2175-83.
Pisano A, Bolignano D, Mallamaci F, D’Arrigo G, Halimi J-M, Persu A, et al. Comparative effectiveness of different antihypertensive agents in kidney transplantation: a systematic review and meta-analysis. Nephrology Dialysis Transplantation. 2020;35(5):878-87.
Fu E. E ans. M, Clase, CM, Tomlinson, L, Diepen, M an, Dekker, FW, & Carrero. 2021:424-35.
Kim J, Park J, Lee J-H, Min JJ, Lee S-H, Lee YT, et al. Comparative efficacy of angiotensin converting enzyme inhibitors and angiotensin receptor blockers after coronary artery bypass grafting. Scientific Reports. 2020;10(1):1716.
Cavero-Redondo I, Saz-Lara A, Lugones-Sánchez C, Pozuelo-Carrascosa DP, Gómez-Sánchez L, López-Gil JF, et al. Comparative effect of antihypertensive drugs in improving arterial stiffness in adults with hypertension (RIGIPREV study). A network meta-analysis. Frontiers in Pharmacology. 2023;14:1225795.
Alcocer LA, Bryce A, De Padua Brasil D, Lara J, Cortes JM, Quesada D, et al. The pivotal role of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in hypertension management and cardiovascular and renal protection: a critical appraisal and comparison of international guidelines. American Journal of Cardiovascular Drugs. 2023;23(6):663-82.
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Copyright (c) 2024 NK NAWAZ, SI KHAN, R KAMAL, T ISMAIL, MA UDDIN, SH ADNAN, FI SIDDIQUI , N IQBAL
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