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COMPARING TWO KINDS
OF BLOOD PRESSURE PILLS:
ACEIs and ARBs
A Guide for Adults
Fast Facts
■ ACEIs and ARBs are two of the many kinds ■ Both kinds of pills (ACEIs and ARBs) do a good job of lowering blood pressure.
problems. The main difference in side effectsis that ACEIs are more likely than ARBs tocause a dry cough. ■ ACEIs and ARBs do not affect cholesterol What does this guide cover?
High blood pressure is treated with different kinds of pills, like
diuretics (water pills), beta blockers, ACE inhibitors (ACEIs), and
ARBs. In fact, people often take more than one kind of pill to
bring blood pressure down.
This guide can help you talk with your doctor or nurse about twoof the many kinds of blood pressure pills. It compares the benefits, side effects, and prices of drugs called ACEIs (pronounced “aces”) and ARBs. The information in this guide comes from a government-fundedreview of research comparing ACEIs and ARBs.
What are ACEIs and ARBs?
Both ACEIs and ARBs relax blood vessels, and that lowers blood
pressure. The names of ACEI drugs and ARB drugs are listed
in the chart below. If you don’t find your drug in the chart, you
are probably taking a kind of blood pressure pill not covered in
this guide.
Why treat high blood pressure?
High blood pressure is one of the most common medical
problems. Most people with high blood pressure have no
symptoms. That’s why it’s called “the silent killer.”
Blood pressure is the stress that blood puts on the inside walls of
the arteries (blood vessels) as it flows through the body. High
blood pressure means that blood is pushing too hard on the
blood vessels. If high blood pressure is not treated, people can
have a stroke, a heart attack, or problems with their kidneys.
Some people can lower their blood pressure by changing to
healthier habits. Losing weight, eating healthy, and getting active
can help. Most people also need medicines to bring their blood
pressure under control. Work with your doctor or nurse to find
medicines that are right for you.
How do benefits of ACEIs and ARBs compare?
■ When taken regularly, both ACEIs and ARBs do a good job of lowering blood pressure. ACEIs and ARBs work equally well.
■ They do not affect cholesterol levels or blood sugar levels.
■ They rarely cause serious problems.
Which drug is right for you may depend on what you think aboutthe side effects and cost.
How do costs compare?
Cost is often a major factor in using a medicine. The charts on
pages 4 and 5 can help you compare the costs of these pills. If
medicines are part of your health insurance plan, check with your
plan about the cost to you.
■ Brand name ACEIs and ARBs have similar costs. ■ Some of the ACEIs are available as generics, which cost less.
How do side effects of ACEIs and ARBs compare?
Both ACEIs and ARBs can cause cough, dizziness, and headache.
The chance of dizziness or headache is about the same with
ACEIs and ARBs. The main difference is that ACEIs are more
likely to cause a dry cough. Sometimes this cough is bad enough
that people need to switch drugs. In research studies:
■ 8 out of 100 people taking an ACEI stop taking it because of ■ 3 out of 100 people taking an ARB stop because of side effects.
Tell your doctor or nurse if you are bothered by one of these side
effects. But do not stop taking your medicine on your own.
What about serious risks?
It is rare, but sometimes people get a drug reaction called
angioedema (pronounced “AN-gee-o-uh-DEE-muh”). In research
comparing ACEIs and ARBs, about 1 out of 10,000 people gets
angioedema.
The most common symptom of angioedema is swelling of the
tongue or lips. Call your doctor or nurse right away if you start
to swell. This might mean you are having a reaction to your
medicine.
Warning: If you are taking an ACEI or an ARB and
become pregnant, call your doctor or nurse to ask
for advice. ACEIs and ARBs can cause serious

! birth defects.
DOSE FOR HIGH
PRICE FOR 1-MONTH SUPPLY2
BLOOD PRESSURE1
1 Doses are similar to those used in the research studies. 2Average Wholesale Price from Drug Topics Redbook, 2007.
Where can I get more information?
For an electronic copy of this guide and materials about comparing
treatments and medicines for other medical conditions,
visit this Web site: www.effectivehealthcare.ahrq.gov
For a free print copy, call the AHRQ Publications Clearinghouse
(800) 358-9295
Ask for AHRQ Publication Number 08-EHC003-2A
For more information about high blood pressure, visit the Medline Plus Web site: http://www.nlm.nih.gov/medlineplus/highbloodpressure.html DOSE FOR HIGH
PRICE FOR 1-MONTH SUPPLY2
BLOOD PRESSURE1
1 Doses are similar to those used in the research studies. 2Average Wholesale Price from Drug Topics Redbook, 2007.
What is the source of this guide?
The information in this guide comes from a detailed review of 61 research
reports. The review is called Comparative Effectiveness of Angiotensin-Converting
Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for
Treating Essential Hypertension
(2007), and was written by the Duke Evidence-
based Practice Center.
The Agency for Healthcare Research and Quality (AHRQ) created the
Eisenberg Center at Oregon Health & Science University to make research
helpful for consumers. This guide was prepared by Bruin Rugge, M.D.,
Sandra Robinson, M.S.P.H., Martha Schechtel, R.N., Theresa Bianco,
Pharm.D., Valerie King, M.D., and David Hickam, M.D., of the Eisenberg
Center. People with high blood pressure helped them write this guide.

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