January 1, 2008Annals of Internal Medicine
Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension
Why the study?
Do ACE inhibitors compared to ARBs improve blood pressure outcomes and major cardiovascular events in adult patients with essential hypertension?
Population
Adult patients with essential hypertension (61 clinical studies)
Comparison
Angiotensin-converting enzyme (ACE) inhibitors vs Angiotensin II receptor blockers (ARBs)
Design
Systematic_review
Follow-up
at least 12 weeks
Authors
Discussion
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Member takes
Implication
Supports agent selection by tolerability; confirms long-term BP equivalence in essential hypertension.
Structured PICO
Do ACE inhibitors compared to ARBs improve blood pressure outcomes and major cardiovascular events in adult patients with essential hypertension?
P
Population
Adult patients with essential hypertension (61 clinical studies)
I
Intervention
Angiotensin-converting enzyme (ACE) inhibitors
C
Comparator
Angiotensin II receptor blockers (ARBs)
O
Outcome
Blood pressure outcomes and major cardiovascular eventssurrogate
ACE inhibitors and ARBs have similar efficacy for blood pressure control in essential hypertension, but ACE inhibitors are associated with a higher incidence of cough.
Limitations
- Few studies involved a representative sample treated in a typical clinical setting over a long duration
- Treatment protocols had marked heterogeneity
- Substantive amounts of data about important outcomes and patient subgroups were missing
Cite This Study
Matchar et al. (2008) studied this question.