Blood pressure lowering efficacy of angiotensin converting enzyme (ACE) inhibitors for primary hypertension

Abstract

There are no clinically meaningful BP lowering differences between different ACE inhibitors. The BP lowering effect of ACE inhibitors is modest; the magnitude of trough BP lowering at one-half the manufacturers' maximum recommended dose and above is -8/-5 mm Hg. Furthermore, 60 to 70% of this trough BP lowering effect occurs with recommended starting doses. The review did not provide a good estimate of the incidence of harms associated with ACE inhibitors because of the short duration of the trials and the lack of reporting of adverse effects in many of the trials.

Specific Transcriptome Changes Associated with Blood Pressure Reduction in Hypertensive Patients After Relaxation Response Training

“…Although guidelines for goals in BP reduction in the elderly remain controversial and the JNC7 goal for diabetics and chronic kidney disease patients is reduction to <130/80 mm Hg, most clinicians in the HTN community are using the traditional target of <140/90 mm Hg as the goal for patients with uncomplicated HTN, the patient population used in this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications 50 –52 and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,53 –55 To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

“…this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications [50][51][52] and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,[53][54][55] To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

Specific Transcriptome Changes Associated with Blood Pressure Reduction in Hypertensive Patients After Relaxation Response Training

“…Although guidelines for goals in BP reduction in the elderly remain controversial and the JNC7 goal for diabetics and chronic kidney disease patients is reduction to <130/80 mm Hg, most clinicians in the HTN community are using the traditional target of <140/90 mm Hg as the goal for patients with uncomplicated HTN, the patient population used in this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications 50 –52 and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,53 –55 To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

“…this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications [50][51][52] and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,[53][54][55] To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

Antihypertensive Efficacy of Hydrochlorothiazide as Evaluated by Ambulatory Blood Pressure Monitoring

“…The office BP reduction with ACE inhibitors (11.4/6.4 mm Hg) and ARBs (11.6/6.5 mm Hg) obtained from Cochrane meta-analysis (43,44) was similar to that obtained from our analysis. Thus, when HCTZ is assessed by outpatient BP measurement, the antihypertensive efficacy seems comparable to that of other antihypertensive drug classes.…”

Angiotensin Receptor Blockers: Pharmacology, Efficacy, and Safety

“…The extent of BP reduction with these 7 ARBs was similar to that produced by ACE inhibitors evaluated under comparable conditions. 34 This observation mirrors the conclusions of a recent report from the Agency for Health Care Research and Quality that compared the relative antihypertensive efficacy of ARBs and ACE inhibitors in 50 studies of patients with essential hypertension and observed no significant difference in these two classes of drugs. The report did note that BP outcomes in trials of longer duration, eg, up to 5 years, were confounded by the coadministration of other antihypertensive drugs in some patients.…”

Specific Transcriptome Changes Associated with Blood Pressure Reduction in Hypertensive Patients After Relaxation Response Training

“…Although guidelines for goals in BP reduction in the elderly remain controversial and the JNC7 goal for diabetics and chronic kidney disease patients is reduction to <130/80 mm Hg, most clinicians in the HTN community are using the traditional target of <140/90 mm Hg as the goal for patients with uncomplicated HTN, the patient population used in this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications 50 –52 and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,53 –55 To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

“…this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications [50][51][52] and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,[53][54][55] To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

Antihypertensive Efficacy of Hydrochlorothiazide as Evaluated by Ambulatory Blood Pressure Monitoring

“…The office BP reduction with ACE inhibitors (11.4/6.4 mm Hg) and ARBs (11.6/6.5 mm Hg) obtained from Cochrane meta-analysis (43,44) was similar to that obtained from our analysis. Thus, when HCTZ is assessed by outpatient BP measurement, the antihypertensive efficacy seems comparable to that of other antihypertensive drug classes.…”

Angiotensin Receptor Blockers: Pharmacology, Efficacy, and Safety

“…The extent of BP reduction with these 7 ARBs was similar to that produced by ACE inhibitors evaluated under comparable conditions. 34 This observation mirrors the conclusions of a recent report from the Agency for Health Care Research and Quality that compared the relative antihypertensive efficacy of ARBs and ACE inhibitors in 50 studies of patients with essential hypertension and observed no significant difference in these two classes of drugs. The report did note that BP outcomes in trials of longer duration, eg, up to 5 years, were confounded by the coadministration of other antihypertensive drugs in some patients.…”

Specific Transcriptome Changes Associated with Blood Pressure Reduction in Hypertensive Patients After Relaxation Response Training

“…Although guidelines for goals in BP reduction in the elderly remain controversial and the JNC7 goal for diabetics and chronic kidney disease patients is reduction to <130/80 mm Hg, most clinicians in the HTN community are using the traditional target of <140/90 mm Hg as the goal for patients with uncomplicated HTN, the patient population used in this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications 50 –52 and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,53 –55 To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

“…this study. The improvements in BP observed in this study are consistent with changes seen with antihypertensive medications [50][51][52] and are consistent with related work showing the impact of MBIs on BP in a variety of populations. 27,[53][54][55] To the authors' knowledge, this is the first study to test such an intervention for a population of unmedicated adults with carefully documented persistent HTN, and the first study to identify genomic determinants associated with the impact of an MBI on HTN.…”

Antihypertensive Efficacy of Hydrochlorothiazide as Evaluated by Ambulatory Blood Pressure Monitoring

“…The office BP reduction with ACE inhibitors (11.4/6.4 mm Hg) and ARBs (11.6/6.5 mm Hg) obtained from Cochrane meta-analysis (43,44) was similar to that obtained from our analysis. Thus, when HCTZ is assessed by outpatient BP measurement, the antihypertensive efficacy seems comparable to that of other antihypertensive drug classes.…”

Angiotensin Receptor Blockers: Pharmacology, Efficacy, and Safety

“…The extent of BP reduction with these 7 ARBs was similar to that produced by ACE inhibitors evaluated under comparable conditions. 34 This observation mirrors the conclusions of a recent report from the Agency for Health Care Research and Quality that compared the relative antihypertensive efficacy of ARBs and ACE inhibitors in 50 studies of patients with essential hypertension and observed no significant difference in these two classes of drugs. The report did note that BP outcomes in trials of longer duration, eg, up to 5 years, were confounded by the coadministration of other antihypertensive drugs in some patients.…”