ARBs reduce CVD risk as much as ACE inhibitors

Angiotension receptor blockers (ARBs) are as effective as ACE inhibitors at lowering risk of cardiovascular disease (CVD), Canadian research suggests.

The ARB telmisartan was found to be just as effective as the current gold standard ACE inhibitor ramipril at lowering CVD risk, delegates were told at the annual ACC in Chicago last week.

The ONTARGET study compared the effects of the two drugs on CVD risk in a group of 25,620 patients, over the age of 55, with CHD or diabetes.

Patients were randomly assigned to receive either ramipril 10mg daily or telmisartan 80mg daily or both for four years and seven months.

Telmisartan was found to be as equally effective at reducing CVD risk as ramipril. The ARB was also better tolerated with lower rates of cough.

However, a combination of an ARB and an ACE inhibitor offered no additional benefit and increased the risk of side- effects such as syncope.

Professor Brian Williams from the University of Leicester, who was a researcher on the study, said despite the findings a large scale switch from the cheaper ACE inhibitors to ARBs or a change in NICE guidance was unlikely.

Primary Care Cardiovascular Society member Dr Sarah Jarvis said: 'Many patients on ACE inhibitors suffer from coughs, so a drug that has so few side-effects will be of huge importance to them.'

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