When it comes to treating high blood pressure, there are many options.
A recent study from Geisinger Medical Center has found that two classes of medicine, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), can be equally effective for newcomers to treatment.
However, ARBs may be less likely to cause side effects. This could mean ARBs are a better choice for some people.
ACE inhibitors and ARBs: A Comparison
Currently, ACE inhibitors are more commonly prescribed as a first-time blood pressure control medicine than ARBs.
Both types of medicines work on the renin-angiotensin-aldosterone system, which regulates our blood pressure.
ACE inhibitors lower blood pressure by blocking an enzyme early in this system.
This action results in less production of a chemical named angiotensin that narrows blood vessels. As a result, blood vessels can stay wider and more relaxed.
On the other hand, ARBs block receptors in the blood vessels to which angiotensin attaches, lessening its vessel-constricting effect.
Both ways lead to more relaxed and wider blood vessels, easing the blood flow and reducing blood pressure.
The Research and Findings
The Geisinger Medical Center team looked at eight electronic health record and insurance claim databases from the United States, Germany, and South Korea.
These databases include nearly 3 million patients who were taking high blood pressure medication for the first time and had no history of heart disease or stroke.
The team found that both ACE inhibitors and ARBs were effective. However, ARBs might cause fewer side effects. This could make them a more attractive option for first-time users.
However, the scientists were clear: they can’t apply these findings to people already taking ACE inhibitors or those on multiple medications.
Guidelines and Recommendations
Professional guidelines suggest several classes of medications as first-line therapies.
The 2017 Guideline from the American Heart Association and the American College of Cardiology lists thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers as the primary medications for treating high blood pressure.
These have been proven to reduce cardiovascular events.
In addition to medication, physical activity and lifestyle changes are always recommended for managing all levels of high blood pressure, even when medication is also necessary.
A Clearer Picture for Treatment
With many medicines to choose from, this study could help provide clarity and guidance to patients and health care professionals.
Understanding the benefits and potential side effects of both ACE inhibitors and ARBs is crucial to making informed treatment decisions.
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The study, led by RuiJun Chen, was published in the Hypertension Journal.
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