NEW YORK, Jan. 7 (UPI) -- Two types of drugs used to treat high blood pressure -- angiotensin receptor blockers, or ARBs, and angiotensin converting enzyme, or ACE inhibitors -- are both safe and effective, according to a new study.
The two classes of drugs, developed about a decade apart, have been the subject of debate, with many doctors using ACE inhibitors first because ARBs were considered possibly less effective.
Researchers in a study at New York University's Langone Medical Center found the two drugs have the same efficacy, making doctors' choice between the two up to patient tolerability and their preference for treatment.
"This is the first time that we have a clear and consistent message from the three buckets of trials of ACE inhibitors and ARBs all of which show that there is not outcome difference between the two agents except for better tolerability of ARBs," Dr. Sripal Bangalore, an associate professor at NYU Langone's Division of Cardiology in a press release. "The results of our analysis are especially important for patients given that many ARBs are now also generic, which reduces their costs."
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Researchers in the study, published in the journal Mayo Clinic Proceedings, reviewed 106 clinical trials involving 254,301 patients conducted between 2000 and 2015. All the studies compared either ACE inhibitors or ARBs to placebo and considered patient risks such as statin use or smoking status.
Where previous analysis has shown ACE inhibitors should be a "first-line therapy" because they were more effective, Bangalore said the difference in sets of trials before 2000 and since is a generation gap in standard of care such as statin use and smoking cessation.
"There has been debate for many years over the safety and efficacy of ACE inhibitors compared to ARBs, with many of them using an 'ACE inhibitor-first' approach, with ARBs regarded as less effective," Bangalore said. "We believe that our study ends the debate and gives physicians the option to prescribe either drug for their patients."
