Renin inhibitors v first‐line antihypertensive drugs for hypertension

First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension

  • Compared to first-line renin angiotensin system (RAS inhibitors), first-line thiazides reduce heart failure (HF) and stroke
  • Compared with calcium channel blockers (CCBs), RAS inhibitors reduce HF, but increase stroke; the magnitude of the reduction in HF outweighs the increase in stroke
  • The lower incidence of cardiovascular events and stroke found with RAS inhibitors compared to beta-blockers may change with additional trials.  
  • In this updated review, only the data for blood pressure are changed by a small amount.  The small differences in effect on blood pressure between the different classes of drugs did not necessarily correlate with the differences in the primary outcomes.

Updated review: First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension