Which is best Lisinopril or Amlodiprine

Best heart protection through ACE inhibitors

The incidence of disturbances in the transmission of stimuli in the heart, for example AV block, was 19 percent lower in the lisinopril group during the five-year observation period. This difference was statistically significant, as Dr. Thomas Dewland from the University of Portland and colleagues report in the journal "JAMA Internal Medicine" (DOI: 10.1001 / jamainternmed.2016.2502).

The original aim of the ALLHAT study was to determine the influence of the various drug classes on the development of coronary artery disease and other complications in the heart and kidneys. To this end, 21,000 patients with hypertension and at least one other cardiac risk factor were randomly assigned to one of the three treatment groups. Those with elevated cholesterol levels were also randomized to receive either pravastatin or standard care. The average age of the participants was 66 and had been followed for five years. At the beginning of the study and then every two years, ECG recordings were also made, which were then used to assess the effect of the various drugs on the transmission of stimuli in the heart.

In addition to medication with an antihypertensive drug other than the ACE inhibitor, the following factors increased the risk: older age, male gender, white skin color, diabetes and - most of all - left heart hypertrophy. It is already known that ACE inhibitors have a positive effect on the latter. According to the guideline of the European cardiological society ESC, the substance class should be given preference in patients with left ventricular hypertrophy. The authors of the present study suspect the effect of the ACE inhibitor on this risk factor as an explanation for the observed superiority in terms of cardiac protection. /