Is ARBs better or ACE inhibitors

Most guidelines recommend angiotensin-converting enzyme (ACE) inhibitors as first-line therapy for patients with cardiovascular disease, 

a new study finds that it may be time to revisit this advice.

Investigators conducted a review of 119 randomized clinical trials of ACE inhibitors and angiotensin II receptor blockers (ARBs) in more than half a million patients. 

They found that ARBs were just as effective as ACE inhibitors when it came to improving blood pressure, slowing nephropathy, and reducing complications in heart failure.

ARBs are also associated with fewer adverse effects, including cough and angioedema. About 20% of patients on ACE inhibitors report cough, while ARBs have a minimal cough incidence.

One benefit of ACE inhibitors is that they are cheaper, but both are available now as generics.

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