Structured Abstract

Contents

• Preface
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
• Introduction
  • Background
  • Scope and Key Questions
• Methods
  • Topic Development
  • Search Strategy
  • Study Selection
  • Analytic Framework
  • Data Extraction
  • Quality Assessment
  • Applicability
  • Rating the Body of Evidence
  • Data Synthesis
• Results
  • Literature Search and Screening
  • Key Question 1 For adult patients with essential hypertension, how do ACEIs, ARBs, and direct renin inhibitors differ in blood pressure control, cardiovascular risk reduction, cardiovascular events, quality of life, and other outcomes?
  • Key Question 2 For adult patients with essential hypertension, how do ACEIs, ARBs, and direct renin inhibitors differ in safety, adverse events, tolerability, persistence with drug therapy, and treatment adherence?
  • Key Question 3 Are there subgroups of patients—based on demographic and other characteristics (i.e., age, race, ethnicity, sex, comorbidities, concurrent us of other medications)—for whom ACEIs, ARBs, or direct renin inhibitors are more effective, are associated with fewer adverse events, or are better tolerated?
• Summary and Discussion
• Future Research
• References
• Acronyms and Abbreviations
• Appendixes
  • Appendix A Exact Search Strings
  • Appendix B Methods for Reviewing Indirect Comparison Studies
  • Appendix C Abstract and Full-Text Screening Criteria
  • Appendix D Data Abstraction Form
  • Appendix E Evidence Table
  • Appendix F Applicability Criteria
  • Appendix G List of Excluded Direct Comparator Studies
  • Appendix H Analyses of Potential Publication Bias

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹. Contract No. 290-02-0025. Prepared by: Duke Evidence-based Practice Center, Durham, NC.

Suggested citation:

Sanders GD, Coeytaux R, Dolor RJ, Hasselblad V, Patel UD, Powers B, Yancy Jr WS, Gray RN, Irvine RJ, Kendrick A. Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension: An Update. Comparative Effectiveness Review No. 34. (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-02-0025.) AHRQ Publication No. 11-EHC063-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2011. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Duke Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0025). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

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