期刊
EXPERT REVIEW OF CARDIOVASCULAR THERAPY
卷 11, 期 6, 页码 705-717出版社
TAYLOR & FRANCIS INC
DOI: 10.1586/ERC.13.42
关键词
ACE inhibitor; all-cause mortality; angiotensin II; ARB; bradykinin; cardiovascular mortality; hypertension; meta-analysis
资金
- Servier
The renin-angiotensin-aldosterone system is a key therapeutic target in hypertension. The latest meta-analysis of mortality reduction with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) in hypertension features 158,998 patients from 20 contemporary hypertension trials. ACE inhibitors and ARBs significantly reduced relative risk for all-cause mortality by 5% (p = 0.032) and cardiovascular mortality by 7% (p = 0.018) in populations with a high prevalence of hypertension (= 66%). ACE inhibitors produced a 10% reduction in relative risk for all-cause mortality (p = 0.004) and a trend toward a 12% reduction in cardiovascular mortality (p = 0.051), whereas ARBs had no effect. On balance, mortality evidence suggests that in hypertension, ACE inhibitors should be considered ahead of ARBs, and ARBs restricted to patients intolerant of ACE inhibitors.
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