Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor (ARBs) are two medications commonly prescribed for treating hypertension, and they work in a similar way. Both lower the chances of a stroke or a heart attack. This study analyzed the safety and efficacy of ACE inhibitors and ARBs.
George Hripcsak, MD, the Vivian Beaumont Allen Professor and chair of biomedical informatics at Columbia University Vagelos College of Physicians and Surgeons and senior author of the study, said, “U.S. and European hypertension guidelines list 30 medications from five different drug classes as possible choices, yet there are very few head-to-head studies to help physicians determine which ones are better. In our research, we are trying to fill in this information gap with real-world observational data."
The researchers examined insurance claims and electronic health records from almost 3 million patients initiating antihypertensive medication with either an ACE inhibitor or an ARB in Europe, Korea, and the United States. In order to drastically reduce bias and balance the two treatment groups, researchers used a range of mathematical tools created by the Observational Health Data Science and Informatics (OHDSI) collaborative network.
The study assessed four cardiovascular outcomes: heart attack, heart failure, stroke, and sudden cardiac death. Fifty-one adverse events in patients who began antihypertensive therapy were also examined.
The researchers discovered that an ACE inhibitor was prescribed to the vast majority of patients (2.3 million). In persons with hypertension, there were no significant differences between the two drug groups when it came to lowering the risk of serious cardiovascular problems. However, a slightly higher risk of gastrointestinal bleeding and pancreatitis was observed among those prescribed with ACE inhibitors, in addition to increased risk of cough and angioedema.
The result of this study suggests that while both classes of drugs are equally effective, ACE inhibitors were associated with slightly higher risk of side effects.