In message <[log in to unmask]>, Nick
JENKINS <[log in to unmask]> writes
>
>Just writing an essay, and wondered what you all thought of losartan, and
>other angiotensin II receptor antagonists? Does it really avoid the ACE
>inhibitor cough? Any nasty experiences?
>
Does it matter? The thing which bothers me about ACE IIs (and ACE Is,
comen to mention it) it the way they are labelled "antihypertensives" -
and have without exception been so licenced and marketed in the UK
before being licenced for the treatment of heart failure.
What you should ask is:
Why do we treat hypertension in the first place?
What is the NNT for preventing CVD events in patients with uncomplicated
hypertension? (OK it varies with age)
How much do ACE inhibitors cost?
Are they more effective in preventing CVD than beta blockers or
thiazides?
Is there *any* justification for prescribing ACE IIs (or Is) for
hypertension apart from in some diabetics or patients with co-existing
heart failure?
What is the point of licencing a drug (whose greatest benefit is likely
to be in the treatment of heart failure) for hypertension only when
there is likely to be no benefit compared to drugs which are a hundred
times cheaper?
Toby
--
Toby Lipman 7, Collingwood Terrace, Jesmond, Newcastle upon Tyne. Tel
0191-2811060 (home), 0191-2437000 (surgery)
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|