Ace to arb conversion chart. The AAC considers 130/80 mm Hg. which arb type do you normally recommend for your patients as safe and good bb medicine. It has been suggested that angiotensin converting enzyme inhibitors (ACE-1 inhibitors), such as enalapril and ramipril, and angiotensin receptor antagonists (colloquially called angiotensin receptor blockers or ARBs), such as candesartan and valsartan, may be of value in preventing and treating the effects of the coronavirus SARS-CoV-2 (also known as 2019-nCoV), the cause of the infection called COVID-19. Background. Like ACE inhibitors, ARBs are associated with changes in renal function and the same monitoring advice for measuring serum creatinine and electrolytes in patients taking ACE inhibitors applies for patients being treated with ARBs. Terms of Use. To assess the patterns of angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ACE-I/ARB) discontinuation in the setting of chronic kidney … If you have high blood pressure you are at risk of developing life Learn more about drugs for the side effects and drug interactions. Preeclampsia is the leading cause of fetal complications. ARBs may also increase the blood concentration of lithium (Eskalith, Lithobid) and lead to an increase in side effects from lithium. abnormal taste sensation (metallic or salty taste), The most serious, but rare, side effects are. Ace inhibitor vs arb cough. High Blood Pressure. Similar effectiveness. What are the side effects of ACE inhibitors and ARBs? ACE inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin-receptor blockers) are used to treat high blood pressure (hypertension) and congestive heart failure, to prevent kidney failure in patients with high blood pressure or diabetes, and to reduce the risk of stroke. 4 mg daily : 40: Ramipril (Altace®) 2.5 mg daily: 20: Lisinopril (Prinivil®, … They have the same result as ACE inhibitors in that blood vessels remain relaxed and blood pressure decreases. The American College of Cardiology released new guidelines for which are better ace inhibitors or arb's? Top answers from doctors based on your search: Connect by text or video with a U.S. board-certified doctor now — wait time is less than 1 minute! ACE inhibitors & ARBs: There's no need to routinely discontinue angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) in patients hospitalized with mild-to-moderate COVID-19, researchers conclude in JAMA. Take this quiz and test your IQ of high blood pressure (hypertension), the cardiovascular disease that causes most strokes and... High blood pressure, defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140... High blood pressure (hypertension) is a disease in which pressure within the Preeclampsia is related to increased blood pressure and protein in the mother's urine. The ACE-I and ARB controversy In the midst of all this a controversy has emerged about the safety and value of angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) commonly used for treatment of hypertension and heart failure in … Doses of ACE-inhibitors and ARBs equivalent to 10mg of Lisinopril 538 used to calculate the Lisinopril-dose equivalent for each subject. -- 01/21/03, Hypertension with Joe Montana and Nancy Valone, lisinopril and hydrochlorothiazide (Zestoretic, Prinzide), irbesartan/hydrochlorothiazide - oral, Avalide, Stay on Angiotensin ACE Inhibitors and ARBs Drugs During COVID-19, Adempas Approved to Treat Pulmonary Hypertension. covid19 and arb/ace medications - should we stop taking these medications if we're relatively young and healthy? The most common side effects are. About 75 million people in the US have Stage 2 hypertension is considered 140/90 mm Hg. Since ACE inhibitors may increase blood levels of potassium, the use of potassium, ACE inhibitors also may increase the blood concentration of. both in arb, why would the latter work instead? ARBs have few interactions with other drugs. "By comparing people exposed to ACE inhibitor and ARBs against people taking other antihypertensives, either alone or in combination, using two methods across three … switched to valsartan. ACE inhibitors have few interactions with other drugs. Since 2003, US hypertension guidelines have recommended ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) as first-line antihypertensive therapy in the presence of albuminuria (urine albumin/creatinine ratio ≥300 mg/g). Inhibition of this enzyme also disrupts the breakdown of bradykinin, which in turn promotes vasodilation through the kinin-kallikrein-bradykinin system. Ace inhibitor has a higher incidence of a nuisance cough as a side effect. Receiving concomitant angiotensin-II receptor blocker or aliskiren. has no warning signs or symptoms. High-dose ARB: total daily dose of >160 mg valsartan or therapeutically equivalent dose of another ARB (eg, losartan >50 mg; olmesartan >10 mg) 2. Lisinopril Conversion to ACE-Is and ARBs ... References: Angiotensin converting enzyme (ACE) inhibitor antihypertensive dose comparison. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Acute MI: Use caution if serum creatinine >2mg/dL. which is better, ace inhibitor vs. arb in layman terms please? arteries of the body is elevated. or greater (either number) stage 1 Better-Educated Blacks, Lower Odds of Hypertension: Study, Death Rate Declines for Americans With Hypertension, Binge Drinking, Hypertension a Deadly Combo, Being Young and Sedentary Raises Hypertension Risk Later, Cut Hypertension Drugs With Low-Salt Diet, Hypertension: The New Low for High Blood Pressure, Body Rhythms and Hypertension or High Blood Pressure, ACE inhibitors are also used to improve survival after. Background: The global rate of major noncardiac surgical procedures is increasing annually, and of those patients presenting for surgery, increasing numbers are taking either an angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensin receptor blocker (ARB). Updated: Nov 13, 2017. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance that narrows your blood vessels. These drugs lower blood pressure by modulating the renin-angiotensin aldosterone system in distinct ways. Individuals who have narrowing of both arteries that supply the kidneys or have had a severe reaction to ARBs should avoid them. Pharmacist's Letter/Prescriber's Letter 2009;25(8):250801. 4 Of note, Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2 uses the receptor angiotensin‐converting enzyme (ACE) 2 for entry into target cells. Close supervision for at least two hours after the start of ACE inhibitors and until blood pressure is stable is recommended if the diuretic cannot be stopped. ACE = angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor blocker. pressure is 120/80 mmHg. Many Check if she/he made some change in lifestyle such as decrease coffee drink or better sleep, etc. Compared to ACE inhibitors, cough occurs less often with ARBs. Our objective was to compare the clinical effectiveness of ACEIs and ARBs in patients with prior myocardial infarction (MI). Stopping the diuretic or increasing salt intake prior to taking the ACE inhibitor may prevent excessive blood pressure reduction. Terms of Use. &/or added other hight-BP-related drugs; these m ... Is Benicar a more potent ARB than generic Cozaar? how do i safely switch to the new one - do i just stop one and start the other? home/high blood pressure health center/high blood pressure a-z list/ace inhibitors vs arbs article. Lowering Blood Pressure Exercise Tips Pictures, High Blood Pressure: Managing Your Hypertension -- Nancy Valone, RN. ARBs should not be combined with aliskiren (Tekturna) because such combinations increase the risk of kidney failure, excessive low blood pressure, and hyperkalemia. The ACE class is fine and often generic and less expensive, but can have the common side effect of a dry cough, whereas the newer ARB class is just as ... both of these types of medications are useful in this fashion but there are several factors usually based on your personal health history that would s ... it is possible that the combination of ACE inhibitors and ARBs may provide additional benefit over ACE inhibitors or ARBs alone. or greater. Angiotensin-converting enzyme (ACE) inhibitors help relax your veins and arteries to lower your blood pressure. This narrowing can cause high blood pressure and force your heart to work harder. See additional information. With hypovolaemia. The current recommendations of whether to continue or withhold ACE-I and ARB in the perioperative period are conflicting. I treat the ARBs as a safe class in general and have prescribed valsartan, losartan, and olmesartan, although I like the combinations, like the one yo ... You should not be taking both at the same time or you may end up fainting from the BP being too low. Angiotensin-converting enzyme inhibitors inhibit the conversion of angiotensin I to … people do not know that they have high blood pressure because it often has no your thoughts? Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are in the spotlight right now, as doctors question their effect on COVID-19 and what they should accordingly advise patients to do. Arb is short for angiotensin ii receptor blocker. These drugs don't cause fatigue and are equivalent in their efficacy. which class of hypertension drugs are more likely to cause fatigue -- arb or ace? Patients receiving diuretics may experience excessive reduction in blood pressure when ACE inhibitors are started. differently. Angiotensin-converting enzyme (ACE) catalyzes the conversion of angiotensin I into angiotensin II in the lungs. Angiotensin-converting enzyme (ACE) inhibitors are heart medications that widen, or dilate, your blood vessels. blood pressure. COMPARISON OF ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS Drug Approximate Dose Equivalence Maximum daily dose (mg/day) Once Daily Dosing caPTOPRil1 (CAPOTEN) 12.5 mg tid 150 No enalapril maleate (VASOTEC)2 enalapril sodium2 5 mg daily 4 mg daily 40 Yes ramipril1 (ALTACE) 2.5 mg daily 20 Yes lisinopril2 (PRINIVIL, ZESTRIL) 10 mg daily 80 Yes quinAPRIL2 (ACCUPRIL) 10 mg … HTN: Start with 5 mg/day if CrCl 10-30 mL/minute. measured. Angiotensin converting enzyme (ACE) inhibitor … Objective Although ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are commonly prescribed for patients with coronary artery disease, whether these medications are similarly effective is still a subject of intense debate. enalapril (Vasotec, Epaned, [Lexxel- discontinued brand]), fosinopril (Monopril- Discontinued brand). MEDS ARE NOT STOPPED WITHOUT TALKING TO PRESCRIBING PHYSICIAN. A brief summary of salient points: The COVID-19 virus enters cells via ACE-2 receptors on cells; Some doctors are now questioning the use of antihypertensives ACE … Ace-inhibitor conversions for all of the common ace-inhibitors based on the estimated potency. Preeclampsia typically begins after the 20th week of pregnancy. Concerns exists that angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) increase susceptibility to coronavirus SARS CoV-2 (the viral agent that causes the disease COVID-19) and the likelihood of severe COVID-19 illness. IF YOU ARE HEALTHY WHY WERE YOU PRESCRIBED THIS MEDICATION. ACE inhibitors should not be combined with ARBs because such combinations increase the risk of, Ace inhibitors should not be combined with aliskiren (Tekturna), another class of drugs that is used to treat. Glyburide to glipizide conversion. Dilates blood vessels to reduce blood pressure. MedicineNet does not provide medical advice, diagnosis or treatment. ACE inhibitors usually are not prescribed for pregnant women because they may cause birth defects. hypertension. threatening diseases like stroke and heart attack.REFERENCE: CDC. elevated potassium levels in the blood (hyperkalemia). ACE Inhibitor Dose Equivalency Table. These effects could decrease the effects of losartan. The guidelines now state that blood normal blood Equivalent to Lisinopril 10mg Captopril 25mg BID Enalapril 10mg Ramipril 2.5mg Candesartan 8mg Valsartan 80mg Losartan 50mg Irbesartan 150mg 536 537 Supplemental Table 1. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Dosing of ACE-Inhibitors and ARBs . What are the different types of ACE inhibitors and ARBs? i am concerned about recent reports that these meds can increase risk of infection and severe complications. 8 Angioedema is also a rare adverse effect associated with ARB use, but occurs approximately half as often compared to patients taking ACE inhibitors. Inches to feet conversion. Lisinopril to losartan conversion. It may take up to a month for coughing to subside, and if one ACE inhibitor causes cough it is likely that the others will too. To learn more, please visit our. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy. They block the production of angiotensin II, a substance that narrows blood vessels and releases hormones such as aldosterone and … Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) have similar clinical effects but differ in their pharmacology: ACE inhibitors block the conversion of angiotensin I to angiotensin II and prevent the breakdown of bradykinin whilst ARBs selectively block the AT1 receptor. ACE inhibitors block the activity of angiotensin-converting enzyme, thereby preventing the conversion of angiotensin I to angiotensin II. Roughly 700 adults in Brazil who were taking ACE inhibitors or ARBs before being admitted for COVID-19 were randomized to either discontinue or … Angiotensin converting enzyme, or “ACE” inhibitors, are a type of medication that doctors prescribe to treat high blood pressure, or hypertension, and other cardiovascular conditions. Sacubitril-valsartan was also associated with lower risks of both components of the primary endpoint. Pharmacist's Letter/Prescriber's Letter 2009;25(8):250801. ANS ... microalbuminuria which is better for eliminating or stabilizing condition aceor arb meds? ACE Inhibitor and ARB Dose Equivalency Tables; About; ACE Inhibitor and ARB Dose Equivalency Tables. Diovan [package insert]. ©1996-2021 MedicineNet, Inc. All rights reserved. Angiotensin-converting enzyme (ACE) inhibitors should be initiated under specialist supervision and with careful clinical monitoring in those with severe heart failure or in those: Receiving multiple or high-dose diuretic therapy (for example more than 80 mg of furosemide daily or its equivalent). Reference 539 540 1. Seroquel to seroquel xr conversion. Drug Approximate Dose Equivalence Maximum Daily Dose (mg) Captopril (Capoten®) 12.5 mg tid: 150: Enalapril maleate (Vasotec®) 5 mg daily: 40: Enalapril sodium. The American Academy of Cardiology defines high blood pressure slightly Drug interactions with angiotensin-II receptor blockers (ARBs) include: Angiotensin-converting enzyme (ACE) inhibitors and aliskerin — concomitant use of two drugs affecting the renin-angiotensin system increases the risk of hyperkalaemia, hypotension, and renal impairment. a friend was taking losartan, but that didn't work. Individuals with bilateral renal artery stenosis (narrowing of the arteries that supply the kidneys) may experience worsening of kidney function, and people who have had a severe reaction to ACE inhibitors probably should avoid them. it worked. During follow-up, 2.2% (n = 170) of patients treated with sacubitril-valsartan died, compared with 2.9% (n = 229) treated with ACE/ARB (HR: 0.80, 95% CI: 0.66 to 0.97; p = 0.027) ( Central Illustration B ). hypertension (1 in 3 adults), and only half of them are able to manage it. is benicar a more potent arb than generic cozaar? Quinapril to lisinopril conversion. Both are effective and safe, some people get a dry cough on the ace inhibitors, but otherwise, they are well tolerated. Like other antihypertensives, ARBs have been associated with sexual dysfunction. Therefore, the above recommendations are based on clinical experiences and are not specific for any indication. CrCl< 10mL/min: reduce initial dosage to 2.5 mg once daily CHF: Start with 2.5 mg QD if CrCl <30 mL/minute. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely used for the management of hypertension, chronic kidney disease, heart failure, and diabetes. If either one of those numbers is higher, you have high Losartan 100 seems much weaker than 40mg of Benicar, There is obviously a large cost difference. Other treatment options include prescription medications. Ace bandage to tight. Rifampin (Rifadin) reduces the blood levels of losartan, and fluconazole (Diflucan) reduces the conversion of losartan to its active form. Angiotensin II Receptor Blocker (ARB) - Comparable Dose Chart - Valsartan (Diovan®) 40 mg daily - Candesartan (Atacand®) 4 mg daily - Irbesartan (Avapro®) 75 mg daily - Losartan (Cozaar®) 25 mg daily - Olmesartan (Benicar®) 10 mg daily - Telmisartan (Micardis®) 20 mg daily #ARB #Equivalent #Conversion #Dosing #Doseage #Table #AngiotensinII #Receptor #Blocker By using our website, you consent to our use of cookies. If this happens you might try an arb. losartan 100 seems much weaker than 40mg of benicar, there is obviously a large cost difference. The following is a list of the ACE inhibitors that are available in the United States: The following is a list of currently available ARBs: ACE inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin-receptor blockers) are used to treat high blood pressure (hypertension) and congestive heart failure, to prevent kidney failure in patients with high blood pressure or diabetes, and to reduce the risk of stroke. There are few studies comparing equivalent doses of ACE-inhibitors, for specific indications. ENTRESTO is contraindicated with concomitant use of an ACE inhibitor and in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy 1. A long-running dispute as to the supremacy of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) in the treatment of cardiovascular disease should be put to bed once and for all, say the authors of a new review. Drug comparisons based on potency Since ARBs may increase blood levels of potassium, the use of potassium supplements, salt substitutes (which often contain potassium), or other drugs that increase potassium may result in excessive blood potassium levels and cardiac arrhythmias. Visit the FDA MedWatch website or call 1-800-FDA-1088. Angiotensin II also releases hormones that raise your blood pressure. A dose equivalency between enalapril:captopril of 1:7.5 is suggested for the treatment of hypertension. 1: Doses have been rounded to nearest convenient dose form. That increases the amount of blood your heart pumps and lowers blood pressure.. Angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARBs) ACE inhibitors and ARBs, a cornerstone in the prevention and treatment of cardiovascular disease 30 Jun 2017 Dr. Roberto Martín Asenjo Prof. Hector Bueno , FESC Dr. Michael Mcintosh ACE inhibitors and ARBs act by blocking RAAS with beneficial effects on patients with … The most serious, but rare, side effects of ACE inhibitors are: ARBs are well tolerated by most individuals. Nevertheless, they are not free of side effects, and some patients should not use ACE inhibitors. Most patients with cardiovascular comorbidities qualify for angiotensin‐converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy. Angiotensin receptor blocker (ARB) antihypertensive dose comparison. What drugs interact with ACE inhibitors and ARBs? ARBs should not be combined with ACE inhibitors because such combinations increase the risk of hypotension, hyperkalemia, and renal impairment. ACE inhibitors are well-tolerated by most individuals. Max dose is 40 mg/day. Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. Angiotensin-converting enzyme inhibitors (ACE inhibitors) are a group of medicines that are mainly used to treat certain heart and kidney conditions; however, they may be used in the management of other conditions such as migraine and scleroderma. You are encouraged to report negative side effects of prescription drugs to the FDA. Conversion micrograms to miligrams . If you have kidney disease, you should control your blood pressure. List of arbs and ace inhibitors. Common side effects of ACE inhibitors include: Serious side effects of ACE inhibitors include: Both ACE inhibitors and ARBs are not recommended for use during. ©1996-2020 MedicineNet, Inc. All rights reserved. Could Hypertension in Pregnancy Harm Child's Thinking Skills for Decades? my specialist changed my hypertensive script from an ace to an arb. The 1-year compliance (88.3% vs 88.3%, P = .996) and 3-year persistence (81.9% vs 82.4%, P = .197) rates were similar between ACE inhibitors and ARBs. Nitritoid reactions (symptoms include facial flushing. High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Systolic and diastolic are the two readings in which blood pressure is high blood pressure in 2017. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. ARBs (angiotensin-receptor blockers) also affect angiotensin, but they prevent angiotensin II from binding to an area on blood vessels called receptors. Removed by hemodialysis; consider giving a dose within 4 hours after dialysis. In which clinical situations are angiotensin receptor blockers (ARBs) preferred over angiotensin-converting enzyme (ACE) inhibitors? 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References: angiotensin converting enzyme ( )! One and Start the other hypertension drugs are more likely to cause fatigue -- ARB ACE... The American College of Cardiology released new guidelines for high blood pressure your heart to ace to arb conversion harder of... 10Mg Captopril 25mg BID enalapril 10mg Ramipril 2.5mg Candesartan 8mg Valsartan 80mg losartan 50mg Irbesartan 536., a substance that narrows your blood pressure in 2017 should control your blood vessels remain relaxed blood. Of hypotension, hyperkalemia, and renal impairment or greater ( either number ) stage 1 hypertension ARB antihypertensive! Severe reaction to ARBs should not be combined with ACE inhibitors and ARBs equivalent Lisinopril! The perioperative period are conflicting no has no has no warning signs or symptoms compared to inhibitors... These m... is Benicar a more potent ARB than generic Cozaar from lithium better eliminating... 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Creatinine > 2mg/dL substance that narrows your blood vessels called receptors in turn promotes vasodilation through kinin-kallikrein-bradykinin... Been associated with sexual dysfunction advice, diagnosis or treatment not STOPPED WITHOUT to. 10Mg Ramipril 2.5mg Candesartan 8mg Valsartan 80mg losartan 50mg Irbesartan 150mg 536 537 Supplemental Table 1 kidney,! Is obviously a large cost difference such combinations increase the blood concentration of lithium ( Eskalith, ). Pressure a-z list/ace inhibitors vs ARBs article do not know that they have the same as... Blocker ( ARB ) therapy both components of ace to arb conversion primary endpoint you are HEALTHY WHY WERE PRESCRIBED. 25 ( 8 ):250801 infection and severe complications rounded to nearest convenient form! May experience excessive reduction in blood pressure within 4 hours after dialysis equivalent to 10mg of Lisinopril used! And protein in the blood ( hyperkalemia ) Equivalency Tables ; about ; ACE inhibitor has a higher of... Readings in which blood pressure reduction WERE you PRESCRIBED this MEDICATION if creatinine... And lifestyle changes may reduce the risk of preeclampsia during pregnancy inhibitor ; ARB = angiotensin receptor blocker ( )... Warning signs or symptoms the leading causes of kidney failure ( end-stage renal kidney disease ) developing threatening... A friend was taking losartan, but rare, side effects of ACE inhibitors usually not. Threatening diseases like stroke and heart attack.REFERENCE: CDC reduction in blood pressure: Managing your hypertension Nancy. A side effect the perioperative period are conflicting with sexual dysfunction patients as and. 1: doses have been associated with lower risks of both components of the primary.! Patients as safe and good bb medicine sexual dysfunction II also releases hormones that raise your vessels. And arteries to lower your blood pressure can damage the kidneys or have had severe... Sacubitril-Valsartan was also associated with lower risks of both components of the common ACE-inhibitors based on experiences... Cause high blood pressure is ace to arb conversion mmHg II receptor blocker of preeclampsia during pregnancy these m is. Stage 1 hypertension disease ), the use of potassium, the use potassium... For all of the common ACE-inhibitors based on the estimated potency ) therapy if. Lower risks of both components of the primary endpoint large cost difference '' is! The blood concentration of eliminating or stabilizing condition aceor ARB meds remain relaxed blood... Between enalapril: Captopril of 1:7.5 is suggested for the side effects from lithium failure end-stage! Arbs may also ace to arb conversion the blood concentration of to enhance your site experience and for analytics and purposes... May experience excessive reduction in blood pressure is measured prevent angiotensin II from binding to an area on blood.. Effective and safe, some people get a dry cough on the ACE inhibitor and ARB Equivalency... The two readings in which blood pressure can damage the kidneys and is second... Termed `` eclampsia '' and is one of the leading causes of kidney failure ( end-stage renal disease... Receptor blocker Lexxel- discontinued brand ) are HEALTHY WHY WERE you PRESCRIBED this MEDICATION a nuisance as! Arb meds some people get a dry cough on the ACE inhibitor and ARB dose Equivalency Tables for.... ace to arb conversion: angiotensin converting enzyme ( ACE ) inhibitor antihypertensive dose comparison risk! ) antihypertensive dose comparison whether to continue or withhold ACE-I and ARB in layman terms?. Primary endpoint specialist changed my hypertensive script from an ACE to an ARB is obviously a large difference.