Researchers from the New York University Langone Medical Center found that newer blood pressure medications are as effective and safe as the older drugs. The findings finally ended the longstanding argument about which type of blood pressure medication works best.
The study analyzed more than 106 random trials and about 250,000 patients. The trials studied the effects of older blood pressure drugs called angiotensin-converting enzyme (ACE) inhibitors and the newer versions called the angiotensin receptor blockers (ARBs).
For years, many health practitioners have used the ACE inhibitors first and have regarded ARBs as the less effective type, said the lead author of the study, Dr. Sripal Bangalore. However, in the new study, both drugs showed similar results. Their only difference? The ARBs are better tolerated and have fewer side effects.
"We believe that our study ends the debate and gives physicians the option to prescribe either drug for their patients," said Bangalore, an associate professor at NYU Langone's department of medicine.
The Two Types Of Blood Pressure Drugs
Angiotensin II is a hormone that regulates blood pressure by restricting the blood flow in the vessels. Whenever the normal blood flow activity is compromised, blood pressure rises.
Both the ACE inhibitors and the ARBs restrict Angiotensin II, but in varying ways. ACE inhibitors prevent the body from creating Angiotensin II, while ARBs replace the hormone in the blood vessels' surfaces, preventing it from restricting the blood flow.
Bangalore said previous researchers may have misinterpreted the efficacy between two drugs because of the lifestyle and healthcare changes that took place during those years. Moreover, the studies in the 1980s and into the 1990s showed the ACE inhibitors as more effective when tested against a placebo drug. The ARBs were also tested alongside a placebo drug in the 2000s.
While past studies suggested ACE inhibitors work better than ARBs, the different results produced by the two drugs were also influenced to the improvements on medical care in the past 10 years. Increased efforts in quitting smoking as well as the widespread use of statins, which are drugs that lower cholesterol, also contributed to the difference. When both drugs are tested at the same time, the results showed similar effectiveness.
Bangalore and his colleagues noted that in their latest analysis, the ARBs had fewer side effects. On the other hand, some patients who took ACE inhibitors had to stop taking the drug due to the prevalence of dry cough.
"The results of our analysis are especially important for patients, given that many ARBs are now also generic, which reduces their costs," added Bangalore.
The research was published in the journal Mayo Clinic Proceedings on Monday.
