[Angiotensin converting enzyme inhibitors or angiotensin II receptor blocker in cardiovascular and renal pathology in 2006: what does EBM teach us?]

Abstract

Inhibitors of the renin-angiotensin system have proved their great value in secondary prevention trials for cardiovascular or renal complications. In favour of the preferred use of angiotensin receptor antagonists stand their excellent tolerance and the possible therapeutic escape seen with angiotensin converting enzyme inhibitors. For the preferential use of the latter, the arguments are the absence of a real proof of any superiority of the angiotensin receptor blockers and their higher cost. The wisdom is to initially use angiotensin converting enzyme inhibitors in secondary prevention excepted when they are not well tolerated. The large ONTARGET cardiovascular prevention trial should help solve this controversy.