ACE-I a ARB – czy różnią się w zakresie wpływu na wskaźniki śmiertelności w nadciśnieniu tętniczym? Metaanaliza

Laura C. van Vark, Michel Bertrand i wsp – Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of reninu2013angiotensinu2013aldosterone system inhibitors involving 158 998 patients Eur Heart J online first (dostępny pełen tekst)

This meta-analysis, which involved almost 160 000 patients, demonstrated that RAAS inhibitors as a class of antihypertensive drugs were associated with a significant 5% relative reduction in all-cause mortality in populations with a high prevalence of hypertension when compared with contemporary control antihypertensive therapy. Stratified subgroup analysis according to class of drug showed a differential treatment effect between ACE inhibitors and ARBs. The overall reduction in all-cause mortality resulted almost completely from the class of ACE inhibitors, which were associated with a statistically significant 10% relative reduction in all-cause mortality, whereas no mortality reduction was observed with the ARBs. In view of the high prevalence of hypertension in the general population, widespread use of ACE inhibitors may therefore result in a considerable gain in lives saved. The results of this study provide a convincing argument to improve treatment adherence in the millions of people around the world suffering from hypertension and its sequelae.

Opracowane na podstawie: Eur Heart J online first / 17 kwietnia 2012