Less popular antihypertensive drugs found to be safer option
During a new multinational observational study, two types of drugs that are recommended as the first treatment for high blood pressure patients were found equally effective in improving cardiovascular outcomes. But the study pointed out that the more popular type causes slightly more side effects.

The study, which analysed claims and electronic health data from millions of patients worldwide, is the largest to compare the safety and efficacy of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), two commonly prescribed antihypertensive drugs.

The study shows that ARBs are associated with fewer side effects than ACE inhibitors. The study focused on first-time users of these drugs. If you're just starting drug therapy for hypertension, you might consider trying an ARB first. If you're already taking an ACE inhibitor and you're not having any side effects, there is nothing that we found that would indicate a need for a change," said the researcher.

The researchers analysed insurance claims and electronic health records from approximately 3 million patients in Europe, Korea, and the United States who were starting antihypertensive treatment with either an ACE inhibitor or an ARB. They employed a variety of cutting-edge mathematical techniques developed by the Observational Health Data Science and Informatics (OHDSI) collaborative network to dramatically reduce bias and balance the two treatment groups as if they had been enrolled in a prospective study.

Using this approach, the researchers tracked four cardiovascular outcomes--heart attack, heart failure, stroke, and sudden cardiac death--and 51 adverse events in patients after they started antihypertensive treatment.

The researchers found that the vast majority of patients were prescribed an ACE inhibitor. There were no significant differences between the two drug classes in reducing the risk of major cardiovascular complications in people with hypertension. Patients taking ACE inhibitors had a higher risk of cough and angioedema, but the study also found they had a slightly higher risk of pancreatitis and gastrointestinal bleeding.

Source:
https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.120.16667
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