ACE inhibitors increase overall survival in patients with high blood pressure

This study compared the overall survival of patients with high blood pressure who took angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) with patients who did not.

ACEI (e.g. Enalapril, Vasotec) are drugs used for reducing blood pressure, which work by modulating the renin-angiotensin-aldosterone system (RAAS) system in the body. RAAS is responsible for electrolyte balance and fluid levels, and it is a key regulator of blood pressure. ARBs (e.g. Losartan, Cozaar) also work on RAAS, but do have a slightly different mechanism of action, blocking the receptor (somewhat like a key in the ignition) on the cell membrane (where messages are transmitted). ARBs are often tried when a patient cannot tolerate ACEIs. Studies in the past have shown a reduction in cardiovascular events (like heart attack, stroke, or heart failure) for patients taking ACEI or ARB. Most studies didn't have enough participants to show a difference in overall survival (or death from any cause). 

This study collected data from 20 clinical trials performed between 2000-2011, altogether including almost 159,000 patients. Patients received either an ACEI, an ARB, or placebo. These trials all measured mortality of any cause (number of patients who passed away during the trial), and lasted at least one year. They found that patients taking ACEIs had a 10% increase in survival. Patients who took ARBs did not seem to have an appreciable overall survival increase.  When the two groups were measured together, they had a 5% increase in survival rate. The increase in cardiovascular-related survival when studies of the whole class of RAAS inhibitors were considered was 7%.

ACE inhibitors, which are often used to reduce blood pressure, may increase overall survival by approximately 10%.  

If you have high blood pressure that is treated with medication, ask your doctor if an ACEI might be right for you.