A recent study from Geisinger Medical Center has found that two types of drugs used to treat high blood pressure for the first time are equally effective—but one may be safer when it comes to side effects. The two drug types are known as ACE inhibitors and ARBs.
Both are widely used, but ACE inhibitors are more commonly prescribed. This study suggests that ARBs might be the better choice for many people starting blood pressure treatment because they may cause fewer problems.
High blood pressure, also known as hypertension, is a common condition that raises the risk of heart attacks, strokes, and other serious health issues. There are several types of medicines used to lower blood pressure.
Among the most recommended are ACE inhibitors (short for angiotensin-converting enzyme inhibitors) and ARBs (angiotensin receptor blockers). Both work by affecting a group of hormones in the body that help control blood pressure, called the renin-angiotensin-aldosterone system.
ACE inhibitors lower blood pressure by blocking a chemical reaction early in the system. This reduces the amount of a hormone called angiotensin, which normally causes blood vessels to tighten. With less angiotensin, blood vessels stay more relaxed, which lowers blood pressure.
ARBs work differently. Instead of stopping the production of angiotensin, they prevent it from doing its job by blocking the spots (receptors) where it attaches in the blood vessels. As a result, blood vessels don’t tighten as much, and blood pressure goes down.
In this study, scientists looked at health records and insurance data from nearly 3 million people in the U.S., Germany, and South Korea.
All the patients had started taking blood pressure medicine for the first time, and none had a history of heart disease or stroke. Researchers compared how well ACE inhibitors and ARBs worked, as well as how often people experienced side effects.
They found that both drugs lowered blood pressure just as well and had similar results in preventing serious events like heart attacks and strokes. However, people taking ARBs were less likely to stop their medication due to unpleasant side effects. This included problems such as persistent cough, which is a known issue with ACE inhibitors.
The study’s authors say that while current medical guidelines recommend a few different classes of drugs as first options—including thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers—this new information can help patients and doctors choose the best fit.
It’s important to note that this study only looked at people who were new to blood pressure medication. The results do not apply to people who are already taking ACE inhibitors or are using multiple blood pressure drugs.
Experts continue to recommend that in addition to medication, people with high blood pressure should make healthy lifestyle changes, like being more physically active, eating a balanced diet, reducing salt, and avoiding smoking. These changes can make a big difference—sometimes even enough to reduce or avoid the need for medication.
This research, led by RuiJun Chen and published in the journal Hypertension, helps clear up some confusion about which blood pressure drugs might be the better choice for those just starting treatment. If you’re beginning to manage high blood pressure, this study suggests that ARBs might offer the same benefits as ACE inhibitors, with fewer side effects.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and coconut sugar could help reduce blood pressure and artery stiffness.
For more information about blood pressure, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
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