Article Text

Download PDFPDF

Review: ACE inhibitors, calcium antagonists, and more intensive blood pressure lowering strategies reduce cardiovascular events
Free

Statistics from Altmetric.com


 
 QUESTION: In patients with hypertension, diabetes mellitus, coronary artery disease (CAD), or renal disease, what are the effects of angiotensin converting enzyme (ACE) inhibitors, calcium antagonists (CAs), and other blood pressure lowering drugs on mortality and major cardiovascular morbidity?

Data sources

In 1995, a registry was established of all large scale trials that were in progress or in advanced stages of planning.

Study selection

Studies were selected if there was a randomised comparison between patients allocated to a blood pressure lowering drug and placebo or to another active antihypertensive agent or to a blood pressure lowering strategy that had a different intensity. Trials had to have a minimum of 1000 patient years of follow up planned and must not have been published before July 1995.

Data extraction

Data were extracted on patient characteristics, discontinuation rates, blood pressure, and major outcomes. Individual patient data or summary data were combined.

Main results

Data from 15 trials (74 696 patients, mean age 62 y, 53% men) were included. Combining data from 4 placebo controlled trials of ACE inhibitors showed that active treatment led to relative reductions of 20% to 30% in stroke, CAD, and major cardiovascular events. Combining data from 2 …

View Full Text

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.