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ARBs ‘do not raise cardiovascular risk’

US researchers have argued against a hypothesis that angiotensin receptor blocker treatment could increase the risk of heart attacks.

The risks of any of myocardial infarction, death, cardiovascular death or angina pectoris were effectively the same for ARBs as for other active treatments or placebo, say the US researchers writing in the British Medical Journal.

After a systematic review and meta-analysis of 37 hypertension and non-hypertension controlled trials involving 147,000 patients, the researchers found that ARBs brought reductions of 10%, 13% and 15% respectively of stroke, heart failure and new onset diabetes, when compared with controls.

In a challenge to a BMJ editorial written in 2004 - which argued the results of the VALUE trial suggested ARBs may lead to higher risk of myocardial infarction - they found no evidence for any relative increase in myocardial infarction and specifically ruled out a absolute 0.3% increase in the risk of death, or cardiovascular death.

Professor Sripal Bangalore, director of research at New York University's cardiac catheterisation laboratory, said: 'In our meta-analysis we found no evidence to support the theory that ARBs increase the risk of myocardial infarction.'

BMJ online 26 April 2011

ARBs 'do not raise cardiovascular risk'