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Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs

You will learn what research says about three types of medicine for high blood pressure, how well they work, how they compare to each other, and their side effects. This information can help you talk with your doctor as you decide which ACEI, ARB, or DRI is best for you.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: October 24, 2011

Comparing ACE Inhibitors and related drugs

How do ACE inhibitors, AIIRAs, and DRIs compare in effectiveness?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: October 1, 2010

“ACE Inhibitors” and “ARBs” To Protect Your Heart? A Guide for Patients Being Treated for Stable Coronary Heart Disease

You have coronary heart disease, a disease affecting the arteries of your heart. You may have had a heart attack or suffer from chest pains with exercise, but your symptoms are not changing. Your coronary heart disease is in “stable” condition. This means that your symptoms have not changed or become worse. Your doctor recommends adding a medicine called an ACE Inhibitor or an ARB. You do not take medicine for high blood pressure (also called “hypertension”).

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: July 9, 2010

Treatment of high blood pressure for people with peripheral arterial disease

When blood pressure is consistently high it can lead to complications such as a heart attack (myocardial infarction) or stroke. Both peripheral arterial disease (PAD), a condition that affects the blood vessels (arteries) carrying the blood to the legs, arms, and stomach area, and high blood pressure (hypertension) are associated with atherosclerosis. This is hardening of the arteries which is caused by deposits of fat, cholesterol and other substances inside the blood vessels. PAD is diagnosed when the blood supply to the legs is restricted causing pain and cramping that limits walking (intermittent claudication). It is measured by the walking distance (on a treadmill) before onset of pain (claudication distance) or ankle brachial index (ABI), the ratio of the blood pressure in the arms to the blood pressure in the legs. If the blood pressure is lower in the legs compared to the arms (ABI of less than 1.0) this indicates blocked arteries in the legs (or PAD). PAD can progress to pain at rest and critical limb ischaemia (sudden lack of blood flow to a limb caused by a blood clot or fatty deposit blockage) that requires revascularisation (restoring the blood flow by opening up the blocked blood vessel) or amputation. Treatment of hypertension to reduce cardiovascular events (heart attack or stroke) and death needs careful consideration in people with PAD. Anti‐hypertensive medications may worsen the PAD symptoms by further reducing blood flow and supply of oxygen to the limbs, and may have long‐term effects on disease progression. The evidence from randomised controlled trials (RCTs) examining the risks and benefits of various anti‐hypertensive drugs on measures of PAD is lacking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Medicines for Early Stage Chronic Kidney Disease: A Review of the Research for Adults With Kidney Disease and Diabetes or High Blood Pressure

This summary will tell you about medicines for people with early stage chronic kidney disease and diabetes, high blood pressure, high cholesterol, or heart or blood vessel diseases. It will explain what research says about the benefits and possible side effects of these medicines. It can help you talk with your doctor about whether or not one of these medicines may be right for you.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: October 11, 2012

Systematic Reviews in PubMed

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