Mortality and Cardiovascular Outcomes with ACE Inhibitors or ARBs

The effects of angiotensin-converting–enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) on mortality and adverse cardiovascular (CV) events have been compared previously, but those studies yielded mixed results. Accordingly, guidelines for managing hypertension and chronic kidney disease generally don’t discriminate between ACE inhibitors and ARBs.

In this observational study, researchers analyzed two large cohorts from the U.K. and China; data were adjusted for baseline differences. The investigators compared rates of 5-year, all-cause mortality and major adverse coronary events (MACE; i.e., nonfatal myocardial infarction, nonfatal ischemic stroke, CV-related death) in 300,000 patients who initiated ACE inhibitors or A…