Combination of ACE Inhibitor and ARB Offers Little Advantage for Renal Function

In patients with baseline nephropathy, angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers (ARBs) reduce proteinuria and preserve renal function. Questions remain about whether the renal effects of ACE inhibitors and ARBs are equivalent, whether a combination of the two classes are more effective than either one alone, and whether either class prevents loss of renal function in patients without nephropathy.

With funding from the manufacturer of telmisartan, researchers randomized 25,620 patients with atherosclerotic disease or advanced diabetes to receive telmisartan (80 mg daily), ramipril (10 mg daily), or both for a median of 56 months. Only 13% of patients had baseline albuminuria. Rates of the primary composite ca…