Two types of blood pressure meds prevent heart events equally, but side effects differ

Science Daily / Hypertension Journal / American Heart Association ^ | July 26, 2021 | RuiJun Chen, Marc A. Suchard, Harlan M. Krumholz, Martijn J. Schuemie, Steven Shea, Jon Duke, et al

[ConservativeMind]

In an analysis of almost 3 million patients taking a single high blood pressure medication for the first time, angiotensin receptor blockers (ARBs) were as good as angiotensin-converting enzyme (ACE) inhibitors at preventing cardiovascular events linked to hypertension, including heart attack, stroke and heart failure. 51 possible side effects and safety concerns were examined: The patients taking ARBs were found to be significantly less likely to develop tissue swelling, cough, pancreas inflammation and bleeding in the digestive tract.

While the class of blood pressure-lowering medicines called angiotensin-converting enzyme (ACE) inhibitors may be prescribed more commonly, angiotensin receptor blockers (ARBs) work just as well and may cause fewer side effects. Currently, ACE inhibitors are prescribed more commonly than ARBs as a first-time blood pressure control medicine.

Both types of medicines work on the renin-angiotensin-aldosterone system, a group of related hormones that act together to regulate blood pressure. ACE inhibitors lower blood pressure by blocking an enzyme early in the system so that less angiotensin, a chemical that narrows blood vessels, is produced, and blood vessels can remain wider and more relaxed. ARBs block receptors in the blood vessels that angiotensin attaches to, diminishing its vessel-constricting effect.

They found no significant differences in the occurrence of heart attack, stroke, hospitalization for heart failure, or any cardiac event. However, they found significant differences in the occurrence of four medication side effects. Compared with those taking ARBs, people taking ACE inhibitors were:

3.3 times more likely to develop fluid accumulation and swelling of the deeper layers of the skin and mucous membranes (angioedema); 32% more likely to develop a cough (which may be dry, persistent, and bothersome);

32% more likely to develop sudden inflammation of the pancreas (pancreatitis); and

18% more likely to develop bleeding in the gastrointestinal tract;

[jmacusa]

150/95?! FRiend you need to be in a hospital with that kind of bp.

And it’s 120/65 at home?

You’ve got something seriously wrong going on.

[phoneman08]

120/65 is bad?

[Labyrinthos]

I take generic benicar (olmesartan medoxomil) — an ARB. Highly effective, and virtually no side effects. Before Benicar went generic, I had to fight my insurer to get the prescription even though the ACE alternatives were making me miserable and were not all that effective.

[MomwithHope]

Bump for later

[Captain Peter Blood]

Did not mention any specific brands

[jmacusa]

120/65 is perfect. You say your blood pressure goes up to 150/95?

If what you’re telling me is correct and you’re getting a bp that high you need to tell your doctor right away or get to a hospital emergency room.

[ConservativeMind]

Different ARBs have different additional benefits, believe it or not.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200815/#!po=23.6842

[going hot]

Is your combination meds for the carotid plaque buildup working?