The angiotensin converting enzyme (ACE) inhibitor lisinopril and the angiotensin receptor blocker (ARB) losartan are equally effective but ACE inhibitors have more side effects. Therefore ARBs like losartan should be used as the first choice. ARBs very precisely block the AT1R as you can see in the upper left diagram. What do you think?
Hello! I've been following your blog with interest. I like ACE inhibitors more for the following reasons.
Weight Reduction and Pharmacologic Treatment in Obese Hypertensives, 2001
In obese hypertensives, ACE inhbitor has a striking effect to lower plasma leptin. Suppresses sympathetic activity, insulinemia, and leptinemia. This appears to play a role in the BP reduction and weight loss.
ACE Inhibitor increases the lifespan in rodents, worms and fruit fly with normal blood pressure, acting as anti-aging drugs
Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of renin–angiotensin–aldosterone system inhibitors involving 158 998 patients, 2012
The observed treatment effect resulted entirely from the class of ACE inhibitors, which were associated with a significant 10% reduction in all-cause mortality (HR: 0.90, 95% CI: 0.84–0.97, P= 0.004), whereas no mortality reduction could be demonstrated with ARB treatment (HR: 0.99, 95% CI: 0.94–1.04, P= 0.683).
This is current new news but it has been known for some time that ARBs like losartan are safer and more effective than ACE inhibitors like lisinopril. Even more effective than losartan are the"insurmountable" ARBs like telmisartan and olmesartan or the most effective but still trade ($$$) Edarbi/azilsartan. HRS, MD,FACC
Hello! I've been following your blog with interest. I like ACE inhibitors more for the following reasons.
Weight Reduction and Pharmacologic Treatment in Obese Hypertensives, 2001
In obese hypertensives, ACE inhbitor has a striking effect to lower plasma leptin. Suppresses sympathetic activity, insulinemia, and leptinemia. This appears to play a role in the BP reduction and weight loss.
ACE Inhibitor increases the lifespan in rodents, worms and fruit fly with normal blood pressure, acting as anti-aging drugs
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286826/#r132
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286826/#r134
https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1005866
https://pubmed.ncbi.nlm.nih.gov/31197356/
Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of renin–angiotensin–aldosterone system inhibitors involving 158 998 patients, 2012
https://pubmed.ncbi.nlm.nih.gov/22511654/
The observed treatment effect resulted entirely from the class of ACE inhibitors, which were associated with a significant 10% reduction in all-cause mortality (HR: 0.90, 95% CI: 0.84–0.97, P= 0.004), whereas no mortality reduction could be demonstrated with ARB treatment (HR: 0.99, 95% CI: 0.94–1.04, P= 0.683).
This is current new news but it has been known for some time that ARBs like losartan are safer and more effective than ACE inhibitors like lisinopril. Even more effective than losartan are the"insurmountable" ARBs like telmisartan and olmesartan or the most effective but still trade ($$$) Edarbi/azilsartan. HRS, MD,FACC