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Newer blood pressure meds “as good as old ones” — but at doing what exactly?

Newer Blood Pressure Drugs as Good as Older Ones: Study Analysis indicates ACE inhibitors and ARBs are equally effective, researchers say

Our Review Summary

iStock_000066897963_SmallThis brief HealthDay story explains the findings of a study by New York researchers comparing two classes of drugs — angiotensin converting enzyme, or ACE, inhibitors versus newer angiotensin receptor blockers, or ARBs — used to treat cardiovascular disease.  It reports on a meta-analysis of more than 100 studies comparing either drug with a placebo or with each other and finds that both types of medications are equally effective.  The only difference being that ARBs tend to produce fewer cases of dry cough as a side effect than do ACE inhibitors.

This story is shorter and less nuanced than a competing Washington Post piece, and it relies excessively on a New York University news release. There is more information about the underlying mechanism of these drugs, something probably of less interest to readers, but less about what is new about this study and why it may be important. The story never clarifies what outcomes we’re talking about with this research — blood pressure, heart attacks, deaths? In addition, the emphasis on the finding of better tolerability does not discuss why this may be – there’s no mention of the greater likelihood of cough and angioedema with ACEIs. Finally, the statement about cost may be somewhat misleading.


Why This Matters

This story, and another by the Washington Post covering the same study, offer new information concerning a debate over the treatment of choice for cardiovascular patients and those at high risk for the disease.  Earlier studies had favored the use of ACE inhibitors of ARBs but this new analysis suggests they are comparably effective.  If that is the case, it gives patient populations and their physicians additional choices when determining the most effective treatment plan.


Does the story adequately discuss the costs of the intervention?


We’ll give the story a grudging satisfactory in this category since it mentions, as a closing statement, that many ARBs are now generic, which means their cost is lower than brand-name equivalents.  But the story would be more helpful to readers if it provided an idea of the comparative costs for the two types of drugs, as well as an average annual cost, since patients remain on them for long periods of time, if not for life. Though more ARBs are now available generically, the costs of generic ARBs generally remain higher than for ACEIs. For many doctors and patients, the use of ACEIs may still be preferred simply because they’re cheaper – even given similar efficacy and a slightly greater need to stop them due to side effects.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story never says what outcomes exactly we’re talking about — deaths, heart attacks, blood pressure? Nor does it say how effective these medications were at improving these outcomes — merely that they are equivalent. We think both of these issues should have been addressed in order to earn a Satisfactory rating here.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

No specific harms are mentioned, just a reference to tolerability. A Washington Post story on the same study at least mentions the dry cough that ACE inhibitors can cause, information which would be most helpful to readers who have been prescribed these medications. Several other side effects could have and likely should have been mentioned, but we’ll give the benefit of the doubt.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

This story is fairly absolute in stating the findings of this research — “Newer blood pressure drugs are as safe and effective as older medications,” the lede says.  The headline claims the drugs “are equally effective.”  We would have been much happier had the story’s statements been more appropriately qualified and had the story mentioned some limitations as the competing Post story did.

Does the story commit disease-mongering?


This story does not appear to commit disease-mongering.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

This story quotes only the primary author as a source, failing to offer additional perspectives.  It also fails to mention that some of the authors have ties to major pharmaceutical firms which, while not directly impacting the quality of the research, is information that readers should be aware of in cases of stories about medications made by such companies.

Does the story compare the new approach with existing alternatives?


The story reports on a study comparing the efficacy of two classes of drugs for treating cardiovascular disease so readers should assume that there are many alternatives on the market.

Does the story establish the availability of the treatment/test/product/procedure?


The story explains that both ACE inhibitors and ARBs have been around for years, the latter since the year 2000 and the former for at least a decade earlier, so readers can easily understand this story is about currently available drugs

Does the story establish the true novelty of the approach?


The story reports, perhaps too conclusively, that the new analysis finds both ACE inhibitors and ARBs to be equally effective, possibly ending a debate among physicians for some time over which medication is preferable to treat cardiovascular disease.  Given the prevalence of the disease among the population, and attention paid to it as a public health concern, the story is justifiably novel.

Does the story appear to rely solely or largely on a news release?

Not Satisfactory

Given that the quotes in this story closely mirror those in the NYU news release, and that no additional sources or material are provided to amplify the story, we believe the writer relied heavily, if not totally, on the prepared news release. We appreciate the fact that the story acknowledged the source of these quotes, but without additional reporting, we don’t think this is sufficient to satisfy the intent or spirit of the criterion. The Washington Post story on the same research provided at lease a minimal additional amount of information, fleshing out the story.

Total Score: 5 of 10 Satisfactory


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