Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), or Direct Renin Inhibitors (DRI) for Adults With Hypertension
Evidence of Benefits: Blood Pressure-Lowering Effects
There were 77 studies that reported a blood pressure outcome for the comparison of ACEIs versus ARBs, and 3 studies that compared the DRI aliskiren with either an ACEI (ramipril) or an ARB (losartan). There was no clear difference in blood pressure-lowering efficacy between ACEIs and ARBs. Data concerning aliskiren were limited. Aliskiren produced a greater reduction in blood pressure compared to ramipril at 12 weeks, with between-group blood pressure (SBP/DBP) differences of -2.7/-1.6 and -2.3/-1.5 mmHg. Aliskiren compared to the ARB losartan demonstrated no significant differences in blood pressure lowering.
- Sanders GD, Coeytaux R, Dolor RJ, et al. Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension: An Update. Comparative Effectiveness Review No. 34. (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-02-0025.) AHRQ Publication No. 11-EHC063-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2011. Available at: http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=696.
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