Angiotensin Receptor Blockers
Given the equal outcome efficacy but fewer adverse events with ARBs, risk-to-benefit analysis in aggregate indicates that at present there is little, if any, reason to use ACE inhibitors for the treatment of hypertension or its compelling indications - Franz Messerli, MD
image by: De Hammer Alphega Apotheek
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Use of antihypertensive drugs generates pressure-packed debate in COVID-19 era
Since the beginning of the pandemic, everything and its opposite has been said about antihypertensive medications. Used in patients suffering from high blood pressure, these medications were first thought to aggravate the consequences of COVID-19 before being considered as a new therapeutic avenue for the same disease.
As a PhD candidate in pharmaceutical sciences at the faculty of pharmacy and the Institute for Research in Immunology and Cancer in Montréal, I believe it is important to observe the need for rigorous scientific research before disseminating conclusions on such a subject, especially during a health crisis.
The different roles of ACE2
COVID-19…
Resources
First line drug treatment for hypertension and reductions in blood pressure according to age and ethnicity
Similar reductions in blood pressure were found to be associated with new use of CCB as with new use of ACEI/ARB in non-black people who did not have diabetes, both in those who were aged younger than 55 and those aged 55 and older.
Losartan
The usual starting dose of losartan potassium tablet is 50 mg once daily. The dosage can be increased to a maximum dose of 100 mg once daily as needed to control blood pressure
Valsartan
The recommended starting dose of valsartan tablets is 80 mg or 160 mg once daily when used as monotherapy in patients who are not volume-depleted.
Heart Drugs Show Promise With Covid-19 Complications
Widely prescribed cardiovascular drugs, some recently suspected in high death rates of infected patients, now are being studied for potential protection.
What is the ACE2 receptor, how is it connected to coronavirus and why might it be key to treating COVID-19?
In the search for treatments for COVID-19, many researchers are focusing their attention on a specific protein that allows the virus to infect human cells. Called the angiotensin-converting enzyme 2, or ACE2 “receptor,” the protein provides the entry point for the coronavirus to hook into and infect a wide range of human cells. Might this be central in how to treat this disease?
Blood pressure medication improves COVID-19 survival rates, research finds
They found that the risk of severe Covid-19 illness and death was reduced for patients with high blood pressure who were taking Angiotensin-Converting Enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB).
Angiotensin converting enzyme (ACE) inhibitors versus angiotensin receptor blockers for primary hypertension
Our analyses found no evidence of a difference in total mortality or cardiovascular outcomes for ARBs as compared with ACE inhibitors, while ARBs caused slightly fewer WDAEs than ACE inhibitors.
Time for Guidelines to Recommend ARBs Over ACE Inhibitors?
The long-running dispute as to the supremacy of these two drug classes should be put to bed once and for all, say the authors of a new review.
What's the Link Between Recalled Blood Pressure Meds and Cancer?
NDMA and NDEA are both the byproducts of various industrial processes, including wastewater treatment. The compounds also appear naturally in some foods, such as cured meats and beer. In the case of the ARB drugs, the problem seems to originate with some of the solvents used to manufacture the active pharmaceutical ingredients, according to the FDA.
Blood pressure medication cancer risks: What we know 1 year after recalls began
It created panic for millions of people who take heart medications every day, but experts say the health risk from quitting is much higher.
Differences in the Clinical Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: A Critical Review of the Evidence
Accordingly, we should aim at establishing a combination treatment based on ACE inhibitors in patients with cardiovascular co-morbidities (CAD, CHF, post-AMI). Rather, ARB agents may be prescribed to patients who do not tolerate ACE inhibitors.
High Blood Pressure Medications: ACE Inhibitors vs. ARBs
ACE Inhibitors and ARBS – these abbreviations may not look all that similar or even have any meaning to you as a patient. However, 1 in 3 adults have high blood pressure and are likely on one of these two types of medication even if they do not know it.
Yet Another Blow To Combination Renin-Angiotensin-Aldosterone System Blockade
ACE inhibitors and angiotensin-receptor blockers have been found to effectively slow progression of kidney disease. It has been theorized that dual blockade of the renin-angiotensin-aldosterone system (RAAS) might prove even more beneficial, but these hopes have not been realized.
Angioedema
ACE Inhibitors (ACEI) •up to 1% incidence •angioedema is a class effect and is not dose dependent – symptoms can occur any time from a few hours up to 10 years after the initial dose (Winters et al, 2013) •more common in African Americans and patients on immunosuppressants •note that angioedema can occur in patients switched to an angiotensin receptor blocker
Angiotensin Receptor Blockers Are Not Just for Hypertension Anymore
Beyond blood pressure control, angiotensin receptor blockers reduce common injury mechanisms, decreasing excessive inflammation and protecting endothelial and mitochondrial function, insulin sensitivity, the coagulation cascade, immune responses, cerebrovascular flow, and cognition, properties useful to treat inflammatory, age-related, neurodegenerative, and metabolic disorders of many organs including brain and lung.
ACE and ARB drugs. To be phased out?
Are you taking an ACE Inhibitor drug? Or perhaps one of their near cousin, ARB (Angiotensin Receptor Blocking) drugs? And did you know they were being phased out?
Use of antihypertensive drugs generates pressure-packed debate in COVID-19 era
The results of the clinical studies in Kansas and Minnesota will provide the first concrete information to clarify the real involvement of losartan, and perhaps this type of antihypertensive in general, in the evolution of COVID-19. At the same time, they will also provide the first answers as to whether this antihypertensive drug is taken at risk or, on the contrary, beneficial in the current context.
BUPA
Angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are mainly used to treat high blood pressure (hypertension) and heart failure. They can also reduce the risk of kidney damage in people with diabetes.
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