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Is there any difference between angiotensin converting enzyme inhibitors and angiotensin receptor blockers for heart

Carmen Rain1, Gabriel Rada2

  • 1Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile.

Medwave
|August 7, 2015
PubMed

Insights

Angiotensin receptor blockers and angiotensin converting enzyme inhibitors show similar effects on mortality for heart failure patients. Angiotensin receptor blockers may lead to fewer adverse events and treatment withdrawals.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Angiotensin receptor blockers (ARBs) are often considered equivalent to angiotensin converting enzyme inhibitors (ACEIs) in heart failure with low ejection fraction.
  • Some guidelines suggest ARBs as first-line therapy due to a potentially better adverse effect profile.

Purpose of the Study:

  • To compare the efficacy and safety of ARBs versus ACEIs in patients with heart failure and low ejection fraction.
  • To synthesize current evidence from systematic reviews and randomized controlled trials.

Main Methods:

  • Systematic search of the Epistemonikos database, screening 30 databases.
  • Inclusion of four systematic reviews encompassing eight randomized controlled trials.
  • Meta-analysis of combined evidence and summary of findings using the GRADE approach.

Main Results:

  • ARBs and ACEIs likely have similar effects on mortality in heart failure patients.
  • Both drug classes may be equivalent in reducing hospitalization risk.
  • Treatment withdrawal due to adverse effects is probably lower with ARBs compared to ACEIs.

Conclusions:

  • ARBs and ACEIs demonstrate comparable efficacy regarding mortality and hospitalization in heart failure with low ejection fraction.
  • ARBs appear to offer a safety advantage with a lower incidence of adverse events leading to treatment discontinuation.

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