THREAD: Are we using ACEIs & ARBs properly? A TI Tweetorial

1/6: British Columbia doctors give 4.5m scripts/year for ACE inhibitors (ACEIs) & angiotensin receptor blockers (ARBs) to control bp. Goal is to ↘️ mortality & morbidity, not simply to ↘️ bp.

#MedEd #hypertension
2/6 BEST EVIDENCE on ARBs & ACEI for #hypertension

3⃣@CochraneHTN systematic reviews:

ACEs v ARBs for htn bit.ly/34vS0hu

BP lowering efficacy of ACEIs for htn bit.ly/30YNIOX

BP lowering efficacy of ACEIs for htn https://t.co/u8dN378QAe

#MedEd Image
3/6 ACEIs over ARBS when considering HARMS 🤔

Both ACEIs & ARBs ↘️ blood pressure to similar extents.... BUT only ACEIs have evidence for a reduction in risk of morbidity & mortality. So they’d be your first choice 🥇

#MedEd #medsafety #ptsafety
4/6 LESS IS MORE when #prescribing 💊

Don’t use more than ½ maximum dose of ACEI. ↗️ doses do NOT meaningfully reduce blood pressure further. ½ of max dose of ACEI/ARB produces 90% & 80% of BP lowering of max dose, respectively.

#MedEd #hypertension Image
5/6 PRICES MATTER 💰💰

As drug classes, ACEIs & ARBs do not differ in blood pressure-lowering efficacy; no individual drug in either category is superior to others. The only known difference is price 🤔

#MedEd #hypertension #drugpricing Image
6/6 CHECK 💊 PRICES when #prescribing

90% of ACEI scripts in BC are for ramipril & perindopril. Cost can differ btwn equally effective 💊 in same class. In BC, 100 days perindopril 8mg = $65; equivalent ramipril 10mg = $23. Pill-splitting may save 💰, depending on price

#MedEd
@threadreaderapp unroll, s'il vous plaît

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Cochrane Hypertension

Cochrane Hypertension Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @CochraneHTN

8 May
THREAD: High blood pressure (hypertension) – what does the best evidence say❓

1/13 A practical tweetorial for clinicians, patients and carers

#hypertension #HTNevidence #MedEd 🩺👩‍⚕️ ImageImage
2/13 What is #Hypertension

Hypertension (high blood pressure) is a very common condition, and is associated with increased 📈 risk for strokes, heart attacks and premature death, so it's worth asking some questions 🤔

#HTNevidence #MedEd #prescribing
3/13 What about SCREENING for #hypertension

Screening for high blood pressure might not be that helpful 😯 and early🕗detection of mild hypertension may not significantly impact health‐related costs in the long term nor improve health outcomes: bit.ly/35P2mcz Image
Read 9 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!