Drugs: Angiotensin-II blockers ARBs vs ACE inhibitors


While ACE inhibitors have been definitively shown to prevent heart attacks and deaths, similar studies with ARBs have not shown this. In clinical trials of patients who have suffered a heart attack, or heart failure, diabetes or hypertension, ARBs neither prevented heart attacks nor prolonged survival compared with ACE inhibitors, other antihypertensive agents or a placebo. This suggests that ACE inhibitors and ARBs are not really interchangeable forms of treatment (Ann Pharmacother, 2005; 39: 470-80).


While taking ACE inhibitors, many patients experience debilitating adverse drug reactions such as a persistent cough, angioedema (deep swelling around the eyes and lips and, sometimes, of the hands and feet), hypotension, or too-low blood pressure, dizziness, headache, fatigue, nausea, high potassium levels, kidney damage, skin rash and taste disturbances. These effects cannot be explained by the blood-vessel-dilating effects of this class of drugs (Expert Opin Pharmacother, 2005; 6: 1851-6).


In short, ACE inhibitors can be said to be associated with the same side-effects seen with ARBs. Yet, ironically, it is for these reasons – and usually due to a persistent cough – that patients are often switched to the second-line alternative of ARBs.

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What Doctors Don't Tell You Written by What Doctors Don't Tell You

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