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Clinical Articles, News & Views

RAAS inhibitors save lives

Treatment with an ACE inhibitor for lowering high blood pressure showed a significant mortality reduction in patients with a high prevalence of hypertension, according to a report1 published in the European Heart Journal.

In the study, 20 different trials including nearly 160,000 randomly selected patients with high blood pressure were treated with renin-angiotensin-aldosterone system (RAAS) inhibitors or control treatment, such as placebo or normal care with a mean follow up of 4.3 years.  RAAS inhibitors showed a 5% reduction in all-cause mortality and a 7% reduction in cardiovascular mortality when compared with control antihypertensive therapy.

However, in a stratified study according to the class of drug, the overall all-cause mortality reduction was a result of the beneficial effect of the class of ACE inhibitors, showing a significant 10% reduction, whereas the AT1 receptor blockers (ARBs) had no reduction.

“The guideline recommended goal of antihypertensive treatment is mortality reduction, however this is the first study that scientifically evaluates the value of RAAS inhibitors on mortality in their main indication of hypertension,” said lead author Professor Laura van Vark (Department of Cardiology, Erasmus in Rotterdam, Netherlands).

Because there are usually no symptoms associated with high blood pressure, most patients don’t realize they have the disease, nor do they know about medication needed.  Treatments for high blood pressure may cause side effects, making it a challenge to patients’ adherence. This is why there is a strong need for medications with beneficial effects on mortality.

For more information about hypertension from the European Society of Cardiology, visit Guidelines.

References

1. van Vark LC, Bertrand M, Akkerhuis KM, Brugts JJ, Fox K, Mourad JJ, Boersma E.  Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of renin–angiotensin–aldosterone system inhibitors involving 158,998 patients. 
European Heart Journal 2012. doi:10.1093/eurheartj/ehs075

Published on: May 24, 2012

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