Hypertension (HTN) is a prevalent cardiovascular condition managed with various antihypertensive agents, including angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers (CCBs). This study aimed to compare the effectiveness and safety of these two classes of medications in reducing blood pressure (BP) and achieving target BP. A comprehensive literature search was conducted evaluating ACE inhibitors (e.g., Enalapril, Captopril, and Lisinopril) and CCBs (e.g., Amlodipine, Diltiazem, and Nifedipine) for HTN management. The inclusion criteria were randomized controlled trials, observational studies, and comparative studies reporting on BP reduction, achievement of target BP, and adverse events. Data were extracted on study design, interventions, participant demographics, and outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. CCBs generally showed superior efficacy in BP reduction compared to ACE inhibitors. In terms of safety, ACE inhibitors were more frequently associated with cough and renal issues, while CCBs, particularly Amlodipine, were more prone to causing peripheral edema. CCBs, especially Amlodipine, generally offer greater BP reduction and a higher target achievement rate than ACE inhibitors. Despite the robust efficacy of ACE inhibitors like Enalapril, the overall safety profiles indicate that CCBs may provide a more effective approach for many patients. However, side effects such as peripheral edema need to be managed. This comparison underscores the need for individualized treatment strategies in HTN management, considering both the effectiveness and side effect profiles of antihypertensive medications.
Key words: Blood pressure, antihypertensive agents, calcium channel blockers, ACE inhibitors
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