Key result
ARBs show no benefit over placebo for death and combined cardiovascular events.
Why the study?
Although guidelines recommend ARBs as preferential drugs for hypertension, their effectiveness in preventing major cardiovascular outcomes and recent concerns regarding adverse effects required reappraisal.
Does Angiotensin receptor blockers (ARBs) prevent all-cause deaths and combined cardiovascular events in patients with hypertension?
Does Angiotensin receptor blockers (ARBs) prevent all-cause deaths and combined cardiovascular events in patients with hypertension?
This review challenges current guidelines by suggesting ARBs do not reduce CVD risk compared to placebo and raises concerns regarding potential associations with cancer and suicide.
Supports reevaluation of ARB use in hypertension; leaves open safety questions from observational data.
Introduction Angiotensin receptor blockers (ARBs) are recommended as preferential drugs in the treatment of hypertension by guidelines. In this review, we reappraise their effectiveness to preventing major cardiovascular outcomes and the recent concerns with new adverse effects.Areas covered ARBs were not superior to placebo in the prevention of all-cause deaths and combined cardiovascular events in seven randomized controlled trials (RCT). Several meta-analyses, with large number of participants, confirmed these findings. Three RCT trials, published in top journals, were retracted due to the uncertain reliability of their findings. Beside the low effectiveness in the prevention of cardiovascular disease (CVD), ARBs were implicated in one meta-analysis with an increased risk of cancer a finding that was not confirmed in another meta-analysis. In observational studies, ARBs were associated with a higher incidence of suicides. In addition, several lots of ARBs were contaminated with carcinogens.Expert opinion ARBs have not been proven to reduce CVD risk and therefore should not be preferential drugs to treat hypertension. The implication of ARBs with suicide and cancer needs to be further studied.
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Bottino et al. (2020) conducted a review in Hypertension. Angiotensin receptor blockers (ARBs) vs. Placebo was evaluated on All-cause deaths and combined cardiovascular events. Angiotensin receptor blockers were not superior to placebo in the prevention of all-cause deaths and combined cardiovascular events across seven randomized controlled trials.
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