Angiotensin receptor blockers and myocardial infarction

[ACE28]

Taking Diovan for approximately 4 years, I was very concerned when I saw this article appear in a very respected medical journal. I don't know which blood pressure medicine I should be taking..

Note: This is only part of the article;;

The interpretation of large scale clinical trials is being increasingly scrutinised by leading journals,1 with great emphasis being placed on the importance of sharing all potential side effects, no matter how trivial, with patients. The Lancet recently published the results of the valsartan antihypertensive long term use evaluation (VALUE) trial, a study of the effects of reducing blood pressure in patients at high risk.2 The angiotensin receptor blocker valsartan produced a statistically significant 19% relative increase in the prespecified secondary end point of myocardial infarction (fatal and non-fatal) compared with amlodipine. A doctor who is a patient of one of the authors (SV) commented that if the incidence of myocardial infarction increased with valsartan it would be an essential component of informed consent to share this information when prescribing valsartan for high risk patients with high blood pressure. These peculiar results led us to examine carefully the . . . [Full text of this article]

[ACE28]

I thought we took these medications to prevent heart attacks. Recently, due to my medical plan I was switched to Cozaar. I don't know if all ARB's the same.

[Lenin]

ACE,

That is dynamite news...I'll try to find the whole study. Bad enough that it compared so poorly to amlodipine (Norvasc) but what if it gave more heart attacks than even PLACEBO
Controlling BP in order to GET a heart attack seems bad medicine indeed.
Thanks for sharing.

My PERSONAL feeling has always been to poo-poo the effectiveness of ARB's because they seemed so very weak to me. Their sole reason for existence seemed sometimes to be the absence of cough making the stronger ACEI's unusable for so many people...the majority I think.

[ACE28]

Lenin,

I was swithed from Altace to Diovan because of the Ace cough. I do believe that Ace's such as Altace and Aceon etc.. are much better choices if you can tolerate the side effects. I think this has been proved recently. I currently take Cozaar, which has not been shown (as yet) to be as bad.

[Lenin]

ACE,
I take Cozaar too. Without my thiazide I find Cozaar to lower my blood pressure approximately ZERO points. I take the losartan only because I HAVE a ton of it and it helps keep potassium up and uric acid down (I have gout that was precipitated by hydrochlorthiazide 100 mg/daily many years ago.)

I would happily take and ACEI but I coughed so long and hard with enalapril that I'd never try another. If indeed, there's more to this story about heart attacks and sartans, I may jettison the lot of them.

I thak god that I respond so very well to thiazides (as long as I take my daily allopurinol )

Do you find that Cozaar does the job for you?