Meta-Analysis of effectiveness or lack thereof of angiotensin-converting enzyme inhibitors for prevention of heart failure in patients with systemic hypertension.
We undertook a meta-analysis of large, randomized controlled trials in hypertensive subjects that compared angiotensin-converting enzyme (ACE) inhibitors with different classes of antihypertensive drugs. Compared with subjects randomized to drugs different from ACE inhibitors, those treated with ACE inhibitors did not show a different risk of congestive heart failure (CHF) (odds ratio 1.03, 95% confidence interval 0.96 to 1.12, p = 0.407). The degree of protection from CHF associated with the use of ACE inhibitors showed a nonsignificant trend to increase with age and the degree of blood pressure control. Thus, the hypothesis that ACE inhibitors are superior to other antihypertensive drugs for prevention of CHF in hypertension remains unproven.
Angeli
Fabio
F
Department of Cardiovascular Disease, Hospital R. Silvestrini, Perugia, Italy
Verdecchia
Paolo
P
Reboldi
Gian Paolo
GP
Gattobigio
Roberto
R
Bentivoglio
Maurizio
M
Staessen
Jan A
JA
Porcellati
Carlo
C
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D006333:Heart Failure / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents