||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.
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
Debra: What are some of the risk factors associated with ACE inhibitors
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