Comparative Effectiveness of ACE Inhibitors and Angiotensin-Receptor Blockers for Hypertension

To explore the relative effectiveness of ACE inhibitors and angiotensin-receptor blockers (ARBs) for lowering blood pressure, researchers reviewed 61 direct-comparison studies of these agents in adults with essential hypertension. Selected studies lasted at least 12 weeks and included at least 20 patients.

Enalapril and losartan were the ACE inhibitor and the ARB studied most frequently (in 24 and 19 studies, respectively). Most studies were 6 months or shorter and excluded patients with secondary causes of hypertension. Overall, ACE inhibitors and ARBs had similar effects on blood pressure; in 37 studies, no statistical difference in blood pressure control was found between the two classes. Monotherapy with either an ACE inhibitor or an ARB…