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Wednesday, December 16, 2009 9:00 AM
Research News: High Blood Pressure Medication May Help Treat Stable Ischemic Heart Disease

Debra: According to a new comparative effectiveness report funded by AHRQ, two medications commonly used to treat high blood pressure appear to be effective in treating stable ischemic heart disease. Here to talk with us about these treatment options is AHRQ researcher and pharmacist, Dr. Carmen Kelly. Dr. Kelly, welcome.

Dr. Kelly: Thank you.

Debra: Dr. Kelly, can you start by telling us a little bit about the treatment offered by the two types of medications used to treat heart disease?

Dr. Kelly: Sure. Treatment featuring the two medications - inhibitors of angiotensin-converting enzyme, or ACE inhibitors, and angiotensin receptor blockers, or ARBs - can lead to a reduction in death, risk of heart attack, risk of stroke, and fewer hospitalizations for heart failure for patients suffering from stable ischemic heart disease.

Debra: Are there standard treatments for stable ischemic heart disease? What can you tell us about those?

Dr. Kelly: Standard treatment for this disease consists of a modification of diet, exercise and medications including aspirin, anti-cholesterol drugs, nitroglycerin and beta blockers. These can keep the disease from worsening. But while standard treatment usually alleviates chest pain, it is not universally successful in reducing risk of heart failure or heart attack. For patients with advanced stable ischemic heart disease, treatment can include heart surgery or angioplasty.

Debra: What are some of the risk factors associated with ACE inhibitors and ARBs?

Dr. Kelly: Risks associated with ACE inhibitors include a persistent cough, sudden fainting, too much potassium in the blood, and dangerously low blood pressure, known as hypotension. Risks associated with ARBs include too much potassium in the blood and low blood pressure.

Debra: Tell us about the findings in the study by AHRQ.

Dr. Kelly: The AHRQ report found that patients with stable ischemic heart disease who take an ACE inhibitor in addition to standard treatment, can reduce the likelihood of several negative outcomes, including death from heart attack or heart failure, non-fatal heart attacks, hospitalization for heart failure, and revascularization, which are surgeries that reroute blood to the heart. Patients who take an ARB in addition to standard medications can reduce their risk of death from a heart-related cause, heart attack or stroke. Also, while some patients and clinicians pursue a course of treatment using both ACE inhibitors and ARBs, the report found that combined treatment does not show any benefit over an ACE inhibitor alone, and that risks of combining these drugs include fainting, diarrhea, low blood pressure and kidney problems.

Debra: Thanks for joining us to talk about the report.

Dr. Kelly: My pleasure.

Debra: To read more about AHRQ’s comparative effectiveness report of ACEs and ARBs for Stable Ischemic Heart Disease, visit www.effectivehealthcare.ahrq.gov.

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