ReviewAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2023
The Pivotal Role of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Hypertension Management and Cardiovascular and Renal Protection: A Critical Appraisal and Comparison of International Guidelines.
Review in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Renin-angiotensin system inhibitor use and survival outcomes in lung cancer: a systematic review and meta-analysis.Frontiers in pharmacology · 2026Pooled it
- GV effects of diabetes mellitus on clinical outcomes of patients with acute heart failure: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Efficacy and safety evaluation of Allisartan Isoproxil in patients with hypertension: a meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled it
- Angiotensin peptide and aldosterone concentrations in response to four classes of blood-pressure-lowering drugs in hypertensive patients: A randomized trial.Journal of human hypertension · 2026Article
- Circular Valorization of Yellowfin Tuna (Molecules (Basel, Switzerland) · 2026Article
- Management of hyperkalaemia in the Italian clinical practice: impact of diverse potassium binders on outcomes and costs in patients with chronic kidney disease and heart failure.International urology and nephrology · 2026Article
- Present and Future Options for Pharmacotherapy in Cardiovascular Disease: Hemodynamic and Mechanistic Therapeutic Targets.Medical sciences (Basel, Switzerland) · 2026Review
- Association of ACEIs/ARBs treatment with clinical outcomes in acute kidney injury: a multicenter retrospective cohort analysis.BMC pharmacology & toxicology · 2026Article
- Associations of urinary isoprostanes with structural and load-dependent arterial stiffness: the Multi-Ethnic Study of Atherosclerosis.American journal of physiology. Heart and circulatory physiology · 2026Article
- Intensive blood pressure control in heart failure with preserved ejection fraction: a symptom-modifying strategy.Heart failure reviews · 2026Review
- Angiotensinogen and its relationship with blood pressure in young adults: the African-PREDICT study.Journal of human hypertension · 2026Article
- The association between Dietary Fat Quality (DFQ) indices, coronary occlusion, and lipid profile among adults living in Central Iran.Lipids in health and disease · 2026Article
- Review
- Genetic and Social Determinants of Renin-Angiotensin-Aldosterone System Inhibitor-Induced Angioedema: A Precision Medicine Health Equity Study.medRxiv : the preprint server for health sciences · 2026Article
- Digital pharmacoepidemiology of angiotensin-converting enzyme inhibitors in Russia.Frontiers in pharmacology · 2026Article
- Medical Management of Coronary Artery Disease: An Update.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025Review
- Role of Angiotensin Receptor Blockers on Cardiovascular Protection in Marfan Syndrome: A Literature Review.Health science reports · 2025Article
- Review
- A comprehensive review of curcumin-based scaffolds in cartilage tissue engineering.Stem cell research & therapy · 2025Review
- Angiotensin-Converting Enzyme Inhibition and/or Angiotensin Receptor Blockade Modulate Cytokine Profiles and Improve Clinical Outcomes in Experimental COVID-19 Infection.International journal of molecular sciences · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Arterial hypertension is the main preventable cause of premature mortality worldwide. Across Latin America, hypertension has an estimated prevalence of 25.5-52.5%, although many hypertensive patients remain untreated. Appropriate treatment, started early and continued for the remaining lifespan, significantly reduces the risk of complications and mortality. All international and most regional guidelines emphasize a central role for renin-angiotensin-aldosterone system inhibitors (RAASis) in antihypertensive treatment. The two main RAASi options are angiotensin-converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs). Although equivalent in terms of blood pressure reduction, ACEis are preferably recommended by some guidelines to manage other cardiovascular comorbidities, with ARBs considered as an alternative when ACEis are not tolerated. This review summarizes the differences between ACEis and ARBs and their place in the international guidelines. It provides a critical appraisal of the guidelines based on available evidence from randomized controlled trials (RCTs) and meta-analyses, especially considering that hypertensive patients in daily practice often have other comorbidities. The observed differences in cardiovascular and renal outcomes in RCTs may be attributed to the different mechanisms of action of ACEis and ARBs, including increased bradykinin levels, potentiated bradykinin response, and stimulated nitric oxide production with ACEis. It may therefore be appropriate to consider ACEis and ARBs as different antihypertensive drugs classes within the same RAASi group. Although guideline recommendations only differentiate between ACEis and ARBs in patients with cardiovascular comorbidities, clinical evidence suggests that ACEis provide benefits in many hypertensive patients, as well as those with other cardiovascular conditions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.