Dr. Sripal Bangalore of the New York University
School of Medicine and colleagues evaluated the cardiovascular outcomes
associated with use of angiotensin receptor blockers (ARB). They conducted a
review of previous randomized controlled trials that compared placebo with ARB
37 controlled trials were evaluated that included 147,020 patients, and
assessed the possible elevated risk for infarction when ARBs were administered.
For the study, 22 trials compared ARBs with active treatments and 17 compared
ARBs with placebo. Out of 147,020 patients, 50.2 % were randomized to controls
while 49.8 percent were randomized to receive ARBs. The average follow-up of
the trials was 3.3 years.
The research reports indicates that angiotensin
receptor blockers usage was not associated with an increased risk of myocardial
infarction when compared to the controls. The results were similar when ARBs
were compared with active treatments or placebo. Dr. Sripal Bangalore said
that "ARBs were also not associated with any increased risk of all-cause
death, cardiovascular death or angina."
The authors further reported that, "In this
meta-analysis we found no evidence to support that angiotensin receptor
blockers increase the risk of myocardial infarction. Our meta-analysis showed
firm evidence of a lack of significant effect of angiotensin receptor blockers
on myocardial infarction, ruling out even a 0.3 % absolute increase in the risk
of myocardial infarction with angiotensin receptor blockers."
It was determined that the angiotensin receptor
blockers, unlike angiotensin converting enzyme inhibitors seem not to have any
special "cardioprotective" effects, even when compared with placebo.
Researchers concluded by stating, "The
risk reduction for the outcomes of stroke, heart failure, and new onset
diabetes with angiotensin receptor blockers is modest."