Comparing Blood
Pressure Medicines
By Carolyn M.
Clancy, M.D.
March 2, 2010
Today, it may
seem easier to get information about a new oven
or drill before you buy one than finding clear
information about the medicine or treatment
that’s best for you. That shouldn’t be the case,
especially for common health conditions like
high blood pressure.
More than 65
million Americans have high blood pressure, or
hypertension. Most people with high blood
pressure have no symptoms, but if it’s left
untreated, it can cause strokes, heart attacks,
or kidney problems. That’s why hypertension is
called "the silent killer."
Some people are
able to lower their blood pressure by losing
weight, eating healthy, and becoming more
active. But, if you’re like most people, you may
need medicines to control your high blood
pressure.
Two common
medicines to treat high blood pressure are ACE
inhibitors (ACEIs) and so-called angiotensin
receptor blockers (ARBs). Both relax blood
vessels to help lower your blood pressure. About
two dozen ACEIs and ARBs are available. Finding
the right one for you depends on balancing the
benefits, side effects, and costs. Having this
information will help you and your doctor decide
on the best drug to treat your high blood
pressure.
My agency, the
Agency for Healthcare Research and Quality
(AHRQ) has developed a
guide on blood pressure pills that compares
ACEIs and ARBs. To develop the guide, scientists
looked at the findings of about 60 studies to
compare how these pills work for different
patients. This research is called comparative
effectiveness research. It focuses on a specific
health condition and identifies the benefits and
risks of treatments.
AHRQ’s guide on
blood pressure pills lays out the pros and cons
of ACEIs and ARBs:
- Both ACEIs
and ARBs, when taken regularly, do a good
job of lowering blood pressure.
- Serious
problems rarely occur with ACEIs and ARBs.
Both types of pills can cause cough,
dizziness, and headache. The chance of
experiencing dizziness and headache is
similar with both pills, but ACEIs are more
likely to cause a dry cough that causes some
people to switch drugs.
- Studies show
that 8 of 100 people taking an ACEI stop
taking it because of side effects, while
only 3 of 100 individuals taking an ARB stop
because of side effects. If you are taking
one of these medicines and are having side
effects, do not stop taking the medicine.
Talk to your doctor or nurse.
- ACEIs and
ARBs do not affect cholesterol or blood
sugar levels.
- While
brand-name ACEIs and ARBs have similar
costs, some ACEIs are available as generics,
which cost less. If your medicines are
covered by your health insurance plan, find
out how much you will have to pay so you can
factor this in your decision.
AHRQ has
sponsored comparative effectiveness research
through its
Effective Health Care Program for many
years. The Federal Government is boosting
funding for this type of work so doctors,
nurses, and patients have good information to
make better-informed decisions. In fact, AHRQ’s
guide on blood pressure medicines is just one of
several available
consumer guides.
Comparative
effectiveness research does not make your choice
for you. That decision is always left to you and
your doctor. But having this information can
help you understand the benefits and risks of
treatments and then help you make a decision on
the right balance for you. With this information
in hand, you and your doctor can work together
to make the best possible treatment decisions.
I’m Dr. Carolyn
Clancy, and that’s my advice on how to navigate
the health care system.
More Information
AHRQ
Podcast
Blood pressure pills (Transcript) Podcast
Help
Agency
for Healthcare Research and Quality
Comparing Two Kinds of Blood Pressure Pills:
ACEIs and ARBs
http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=31
Effective Health Care Program
http://effectivehealthcare.ahrq.gov/index.cfm
Current as of March 2010
Internet Citation:
Comparing Blood Pressure Medicines.
Navigating the Health Care System: Advice
Columns from Dr. Carolyn Clancy, March 2, 2010.
Agency for Healthcare Research and Quality,
Rockville, MD. http://www.ahrq.gov/consumer/cc/cc030210.htm
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