ACE inhibitor side effects

Lowering blood pressure comes at a price

Patients with diagnosed hypertension often receive ACE inhibitors. But why put up with their adverse effects when equally efficacious but less noxious alternative drugs exist?

Photo
The recent ACC/AHA Guidelines have increased the number of patients said to have hypertension by up to 40 percent.
Source: Inselspital, Bern University Hospital

The recent ACC/AHA Guidelines have increased the number of patients said to have hypertension by up to 40 percent (new 130/80 mmHg). The international recommendation is to treat hypertension with angiotensin converting enzyme inhibitors (ACEIs). These drugs, however, have significant adverse effects: Often a chronic dry cough leads to patients withdrawing from treatment. On rare occasions, ACEIs cause angioedema (sudden swelling of the tongue and airways) with potentially fatal outcome. But an alternative and safer drug class exists, as a study by the Department of Cardiology at Inselspital, Bern University Hospital, was able to demonstrate in the «Journal of the American College of Cardiology».

Comparative Efficacy – less serious side-effects

The research team of Prof. Dr. med. Franz Messerli and Prof. Dr. med. Stefano Rimoldi compaired the antihypertensive action of ACEIs and angiotensin receptor blockers (ARBs) in patients without underlying cardiovascular condition and those with coronary artery disease, heart failure or chronic kidney disease. They also examined the adverse effects in each patient group in retrospective. In total, data of 254,301 patients was included in the comparison.

The study demonstrates a comparable efficacy of ARBs to ACIs, as the surrogate endpoint of blood pressure was lowered to a similar extent by the two drug classes. More importantly however, in patients with hypertension and hypertension with compelling indications there was no difference with regard to the outcomes of all-cause mortality, cardiovascular mortality, myocardial infarction, heart failure, stroke, and end-stage renal disease. Under ARB-treatment fewer adverse events were reported, specifically much less angioedema. There was no dry cough and ARBs in some cases even reduced nonspecific symptoms occurring with hypertension such as headaches.

New standard treatment guidelines in sight?

20 to 30 million patients are currently taking ACE inhibitors worldwide. This could statistically result in several hundred fatalities per year through angioedema. Because efficacy is similar but adverse events are fewer with ARBs, risk-to-benefit analysis in aggregate points to these drugs as better frist treatment option. In Switzerland 20 percent of hypertension patients still are prescribed ACE inhibitors.


Source: Bern University Hospital

29.03.2018

Read all latest stories

Related articles

Photo

Blood thinners

Experts' plea for anticoagulant dosage guidelines

Rutgers researchers have found a way to reduce bleeding in patients following bariatric surgery. The study, which appeared in the journal Surgery for Obesity and Related Disorders, was conducted by…

Photo

Anticoagulants vs coronavirus

Preventive blood thinning could reduce risk of Covid-19 death

Patients given preventive blood thinning drugs (prophylactic anticoagulants) within 24 hours of admission to hospital with Covid-19 are less likely to die compared with those who do not receive them,…

Photo

Outsmarting the immune system

'Super-human’ red blood cells for precise drug delivery

A team of physicists from McMaster University has developed a process to modify red blood cells so they can be used to distribute drugs throughout the body, which could specifically target infections…

Related products

Alsachim, a Shimadzu group company – Dosinaco

Clinical Chemistry

Alsachim, a Shimadzu group company – Dosinaco

Alsachim, a Shimadzu Group Company
Analyticon Biotechnologies AG - Urilyzer 100 Pro

Urinalysis

Analyticon Biotechnologies AG - Urilyzer 100 Pro

Analyticon Biotechnologies AG
Analyticon Biotechnologogies – Hemolyzer 3 NG / Hemolyzer 5 NG

Blood Cell Counter

Analyticon Biotechnologogies – Hemolyzer 3 NG / Hemolyzer 5 NG

Analyticon Biotechnologies AG
ASP Lab Automation – Recapper KapSafe

Sample Processing

ASP Lab Automation – Recapper KapSafe

ASP Lab Automation AG
ASP Lab Automation – Tube Sorter SortPro

Sample Processing

ASP Lab Automation – Tube Sorter SortPro

ASP Lab Automation AG
Beckman Coulter – DxH 500 Family

Blood Cell Counter

Beckman Coulter – DxH 500 Family

Beckman Coulter, Inc.
Subscribe to Newsletter