ACE inhibitors and ARBs, which are commonly prescribed to combat high blood pressure, also are used for treatment of a heart attack and chronic heart failure. Captopril (sold as Capoten), the first ACE inhibitor to be taken orally, has been commonly available in the United States since the early 1980s. ARBs, first approved for use in the United States in the mid-1990s, often are prescribed when a patient has adverse effects to ACE inhibitors, but ACE inhibitors are used more commonly.

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 (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.

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 include fainting, diarrhea, low blood pressure and kidney problems.

The report found that existing studies provide few data on the medications' benefits or harms in specific populations such as people of different genders, ethnicity, diabetic status or those who have or don't have high blood pressure.

SOURCE Agency for Healthcare Research & Quality