Key result
Angiotensin receptor blockers may be ineffective in preventing all-cause mortality and major cardiovascular events, and potentially harmful to the kidneys in diabetic and elderly patients.
Why the study?
Do Angiotensin receptor blockers (ARBs) prevent all-cause mortality and major cardiovascular events in patients with hypertension and high cardiovascular risk?
Do Angiotensin receptor blockers (ARBs) prevent all-cause mortality and major cardiovascular events in patients with hypertension and high cardiovascular risk?
This review challenges the widespread preference for ARBs in hypertension management, citing meta-analyses that show lack of efficacy for mortality and CV events, alongside potential renal harm.
Caution advised with ARBs in diabetic or elderly hypertensives; challenges consensus but remains hypothesis-generating from Level 5 evidence.
Angiotensin receptor blockers (ARBs) are the most commonly used among blood pressure-lowering drugs worldwide, despite the absence of sound evidence of effectiveness in large and unbiased clinical trials. Meta-analyses published in recent years and reviewed here have not given support to this preference, suggesting that ARBs may be ineffective in the prevention of all cause mortality and major cardiovascular events (particularly myocardial infarction). There is evidence that ARB can be harmful for the kidney, particularly in patients with diabetes and in the elderly. It may be time to call for a moratorium on the preference for ARB in the management of hypertension and in patients with high cardiovascular risk.
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Fuchs et al. (2015) conducted a review in Hypertension and high cardiovascular risk. Angiotensin receptor blockers (ARBs) was evaluated on All cause mortality and major cardiovascular events. Angiotensin receptor blockers may be ineffective in preventing all-cause mortality and major cardiovascular events, and potentially harmful to the kidneys in diabetic and elderly patients.
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