Key result
ACE inhibitor treatments significantly reduced pulmonary function (FEV1, FEV1%, and FVC) compared to ARBs and healthy controls, whereas ARBs did not impair normal respiratory functions.
Why the study?
Hypertensive patients are vulnerable to antihypertensive adverse effects that reduce adherence, prompting an evaluation of the safety profile of ACEi versus ARBs on respiratory functions.
Do ACE inhibitors and ARBs differentially affect pulmonary function in hypertensive patients?
Observational
Do ACE inhibitors and ARBs differentially affect pulmonary function in hypertensive patients?
ACE inhibitors, but not ARBs, are associated with impaired pulmonary function in hypertensive patients, suggesting ARBs may be preferable in patients at risk for respiratory adverse effects.
OBJECTIVES: Hypertension is a very common cardiovascular disease. Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are widely used to treat hypertension. Many patients with hypertension are vulnerable to the antihypertensive adverse effects, which potentially reduces the adherence rate. Therefore, we conducted this study in order to evaluate the safety profile of both classes (ACEi and ARBs) on respiratory functions. METHODS: Two main groups of subjects were studied: first group is healthy control subjects and the second group is hypertensive patients, which was subdivided into subgroups in order to investigate the effect of all tested medications (captopril, enalapril, lisinopril, losartan, and valsartan). Respiratory efficiency was evaluated by measuring pulmonary function tests: FEV1, FVC, and FEV1%. Measurements were done using micromedical spirometer. RESULTS: We found that ARBs do not impair normal respiratory functions as measured by FEV1, FEV1%, and FVC in hypertensive patients. While ACEi treatments significantly reduced FEV1, FEV1%, and FVC compared to the other groups. CONCLUSIONS: ARBs are not associated with any harmful effects on respiratory functions in hypertensive patients, unlike ACEi. As such, they could represent a first-choice treatment for hypertensive patients who are at high risk to the respiratory adverse effects.
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Jabbar et al. (2021) conducted an observational in Hypertension. ACE inhibitors and ARBs vs. Healthy controls and between medication classes was evaluated on Pulmonary function tests (FEV1, FVC, and FEV1%). ACE inhibitor treatments significantly reduced pulmonary function (FEV1, FEV1%, and FVC) compared to ARBs and healthy controls, whereas ARBs did not impair normal respiratory functions.
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