ACE Inhibitor as Effective as More Expensive Blood Pressure Drug

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During a median follow-up time of 56 months, the incidence of deaths and adverse events was almost identical in the two groups -- 16.5 percent for those taking ramipril and 16.7 percent in the telmisartan group. It was also about the same in a group prescribed both medications, 16.3 percent, but there was a higher incidence of side effects such as abnormally low blood pressure and kidney problems among those taking the combination drug therapy.

ARBs still have a place in treatment of high-risk people such as those in the study, Yusuf said. "About 20 to 30 percent of people who take ACE inhibitors have side effects that make them stop," he said. The most common side effect is cough.

"On the other hand, ARBs seem to be valuable when added to an ACE inhibitor in patients with heart failure," McMurray said. The new study group did not include people with heart failure.

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Switching from an ARB to an ACE inhibitor can reduce the cost of medical care, Yusuf said. Pill for pill, the cost of an ARB is about 20 percent higher than for an ACE inhibitor in Canada, he said.

More information

Learn more about ACE inhibitors, ARBs and other drugs for high blood pressure from the American Heart Association.

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