ARBs or ACE-inhibitors – Is There Now a Relevant Difference?
Fri, January 15, 2010 at 03:00AM Angiotensin II is the villain in high blood pressure, or hypertension, and there are several successful drugs that work by neutralizing it. The angiotensin receptor blockers (ARBs) and the angiotensin-converter inhibitors (ACE-inhibitors) are classes of drugs that are very effective and safe in the control of hypertension. And there hasn’t been much to choose between them – until recently. Now a study of the occurrence and development of Alzheimer’s disease in patients with cardiovascular disease has shown a surprising difference between the two types of drug; it’s published in the British Medical Journal.
Researchers analyzed US Veterans Affairs records of 800,000 predominantly male patients aged 65 or more with cardiovascular disease. Over a 4-year period, patients taking ARBs were less likely to develop dementia or Alzheimer disease, to be admitted to a nursing home, or to die than were patients taking the ACE-inhibitor lisinopril, or other blood-pressure drugs, such as beta-blockers or calcium channel blockers. There was a 19% reduction in the risk of dementia (Alzheimer’s or vascular dementia) in those taking an ARB compared with those taking the ACE-inhibitor; and compared with those taking another cardiovascular drug the reduction was 24%. Patients who were taking both ARBs and ACE-inhibitors had a further risk reduction; it amounted to 46% compared with those taking an ACE-inhibitor alone.
Furthermore, patients taking ARBs who had pre-existing Alzheimer’s were about half as likely to be admitted to a nursing home than those taking another cardiovascular drug. Mortality during the study period was also lower with ARBs than with the ACE inhibitor or other blood-pressure drugs.
This exciting finding is an example of pharmacological research that can sometimes lead to clear-cut advances in preventive medicine, even if they only emerge after a number of years. The possibility of an anti-angiotensin II-vaccine, mooted in 2008, is an additional direction that may prove interesting in more than just blood-pressure control.
Reader Comments (3)
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Hope to hear more developments from this research. If successful, this would truly benefit a lot of patients suffering from the disease. I will be visiting here often for updates.
Linda Flink
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