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.