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Antihypertensive Therapy

Bangalore S, Kumar S, Wetterslev J et al. BMJ 2011;342:d2234.

In response to VALUE (Valsartan Antihypertensive Long-Term Use Evaluation) trial data, which showed an increased risk of myocardial infarction (MI) with an angiotensin receptor blocker (ARB), the current authors evaluated cardiovascular and other outcomes with various ARBs. They found that ARBs did not increase the risk of MI compared with controls (placebo or active treatment), but were associated with reduced risk of stroke, heart failure, and new-onset diabetes.

 

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely prescribed for the treatment of hypertension and heart failure, as well as for other indications. Data from the VALUE (Valsartan Antihypertensive Long-Term Use Evaluation) trial, in which the ARB valsartan was compared with the calcium-channel blocker amlodipine in patients with hypertension at high cardiovascular risk, unexpectedly showed an increased risk of myocardial infarction (MI) with valsartan [1]. This issue was discussed in several subsequent reports, with no definitive conclusions drawn.

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