ACEIs for cardiovascular risk reduction Have we taken our eye off the ball?

Andrew Sindone*, Jonathan Erlich, Vlado Perkovic, Michael Suranyi, Henry Newman, Choon Lee, Edward Barin, Simon D. Roger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background

Hypertensive patients have an increased risk of cardiovascular (CV) events. There is debate whether angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) offer similar reductions in CV risk.

Objective

This article discusses some of the recent evidence for the prevention of CV events and mortality with ACEIs and ARBs, and the rationale for using an ACEI as the preferred agent for comprehensive CV risk reduction in specific patient populations.

Discussion

ACEIs and ARBs are structurally and functionally very different agents; they are not interchangeable. Prescriptions for ARBs are increasing in Australia. However, clinical trial evidence suggests possible advantages of ACEIs over ARBs, particularly in terms of survival benefit. Many patients with hypertension have other CV risk factors that may affect medication choice. The aim of treatment should not be just to lower blood pressure, but to reduce absolute CV risk.

Original languageEnglish
Pages (from-to)634-638
Number of pages5
JournalAustralian Family Physician
Volume42
Issue number9
Publication statusPublished - Sep 2013
Externally publishedYes

Keywords

  • angiotensin-converting enzyme inhibitors
  • angiotensin receptor antagonists
  • cardiovascular diseases
  • risk assessment
  • hypertension
  • CONVERTING-ENZYME-INHIBITORS
  • ANGIOTENSIN RECEPTOR BLOCKERS
  • RANDOMIZED CONTROLLED-TRIAL
  • MYOCARDIAL-INFARCTION
  • HEART-FAILURE
  • DIABETIC-NEPHROPATHY
  • CLINICAL-TRIALS
  • OUTCOMES
  • EVENTS
  • PERINDOPRIL

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