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This CME/CE activity is provided by PRIME Education, Inc. (PRIME®) and is accredited for a multi-disciplinary audience of health care practitioners. This activity is supported by contract number HHSA290201200021I from the Agency for Healthcare Research and Quality. User data collected through this activity will reside on PRIME's educational portal for use by AHRQ.

Updates on the Treatment of Essential Hypertension: A Summary of AHRQ's Comparative Effectiveness Review of Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Direct Renin Inhibitors

Credit for this CME/CE activity has expired.

You can still access the program, but will not receive a certificate.

Program Overview

Activity Description

Hypertension, which affects approximately 75 million American adults and three-fourths of the population over 75 years of age, is the primary attributable risk factor for death worldwide. Given its negative effects on numerous organs, hypertension causes substantial morbidity and is responsible for excessive health care costs. Whereas lifestyle interventions including diet and exercise contribute to managing hypertension, many people with the disease require medication to lower blood pressure and to avoid complications. Among the most common therapeutic options are agents that target the renin-angiotensin-aldosterone system (RAAS). These agents are grouped into 3 main classes: angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and direct renin inhibitors. Given marked differences in their mechanisms of action, one might expect that the RAAS-targeted therapies would vary in their efficacy and side-effect profiles. To systematically evaluate the comparative benefits and harms of ACE inhibitors and ARBs for patients with essential hypertension, the Agency for Healthcare Research and Quality (AHRQ) commissioned a comparative effectiveness review of published studies on these 2 therapy classes. A technical report on the review was published in 2007. An updated review, which added evaluations of direct renin inhibitors, was published in 2011. The key methods and findings from these AHRQ systematic reviews are summarized in this educational journal article.

Learning Objectives

At the conclusion of this activity, the participant should be able to:

  • Compare the effectiveness of the therapy options for controlling blood pressure and reducing risks of cardiovascular mortality and morbidity
  • Describe key differences in side-effect profiles, tolerability, and persistence outcomes associated with the therapy options
  • Summarize conclusions regarding the comparative effectiveness and harms of the therapy options on prespecified subpopulations of patients

Target Audience

This CME activity is designed to meet the educational needs of physicians, pharmacists, nurses, and case managers.

Method of Participation

To receive a certificate for this activity, you should:

  • Complete the learner assessment pretest
  • View the entire activity online
  • Complete an online evaluation & post-test
  • Print your certificate online

The estimated time to complete this activity, including review of the materials, is 1.0 hour.

Term of Approval

September 30, 2011 through September 30, 2013. Original release date: September 30, 2011.

Acknowledgement of Support

There is no fee for this CME/CE activity. This activity is sponsored by PRIME Education, Inc (PRIME®) and funded under contract HHSA290201200021I from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (HHS).

Faculty Biographies and Disclosures

Click faculty name to view full biography.

Author

Ben Powers, MD, MHS
Assistant Professor of Medicine
Duke Division of General Internal Medicine
Center for Health Services Research in Primary Care
Durham VA Medical Center
Assistant Scientific Editor, North Carolina Medical Journal
Durham, NC

 

Contributing Author

Laurence Greene, PhD
Director of Scientific Education and Outcomes
PRIME Education, Inc.
Tamarac, FL

Contributing Author

Lisa Balfe, MPH
Medical Writer
PRIME Education, Inc (PRIME)

Planner

Heidi Wynn Maloni, PhD, ANP-BC, CNRN, MSCN
National Clinical Nursing Director
Department of Neurology
Multiple Sclerosis Center of Excellence, East
Veterans Affairs Medical Center
Adjunct Faculty
Trinity Nursing Program School of Professional Studies
Trinity Washington University
Clinical Preceptor and Instructor
Advanced Practice Programs
The Catholic University of America School of Nursing
Washington, DC

Planner

Michele B Kaufman, PharmD, CGP, RPh
President, PRN Communications Inc.
Editor, Pharmacovigilance Forum, P&T Journal
NYCSHP Secretary
Adjunct Faculty
Touro College of Pharmacy
New York, NY

Peer Reviewer

Mori J Krantz, MD, FACC
Associate Professor of Cardiology
University of Colorado
Director, Cardiovascular Risk Reduction Program
Denver Health
Director, Cardiac Rehabilitation
Colorado Prevention Center
Denver, CO

Peer Reviewer

Donna M Chiefari, BSc (Pharm), PharmD, RPh, FASHP
Adjunct Faculty & Preceptor
Albany College of Pharmacy
Albany, NY

Peer Reviewer

Kathleen A Jarvis, MS, RN, CCM
Clinical Educator
Alere Healthcare
Fort Lauderdale, FL

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Accreditation/Credit Designation

This program is no longer accredited.

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Faculty Disclosures

Faculty Name
Advisory Board Consultant Grants / Research Salary / Contractual Supported Promotional Education Stock / Shareholder Other Financial Support
Ben Powers, MD, MHS
Speaker
None None None None None None None
Laurence Greene, PhD
Contributor
None None None None None None None
Lisa Balfe, MPH
Contributor
None None None None None None None
Heidi Wynn Maloni, PhD, ANP-BC, CNRN, MSCN
Planner
None sanofi-aventis None None None None None
Michele B Kaufman, PharmD, CGP, RPh
Planner
None None None None None None None
Mori J Krantz, MD, FACC
Reviewer
None None GSK Lovaza Study None None None None
Donna M Chiefari, BSc (Pharm), PharmD, RPh, FASHP
Reviewer
None None None None None None None
Kathleen A Jarvis, MS, RN, CCM
Reviewer
None None None None None None None
Chris R Prostko, PhD
Scientific Program Director
NoneNoneNonePRIME®NoneNoneNone
Lynn Goldenberg, RN, BSN
Director of Accreditation & Compliance
NoneNoneNonePRIME®NoneNoneNone

Disclosure Policy

PRIME Education Inc (PRIME®) endorses the standards of the ACCME, as well as those of the AANP, ANCC and ACPE, that require everyone in a position to control the content of a CME/CE activity to disclose all financial relationships with commercial interests that are related to the content of the CME/CE activity. CME/CE activities must be balanced, independent of commercial bias and promote improvements or quality in healthcare. All recommendations involving clinical medicine must be based on evidence accepted within the medical profession.

A conflict of interest is created when individuals in a position to control the content of CME/CE have a relevant financial relationship with a commercial interest which therefore may bias his/her opinion and teaching. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, stocks or other financial benefits.

PRIME® willidentify, review and resolve all conflicts of interest that speakers, authors, course directors, planners, peer reviewers, or relevant staff disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. Disclosure information for speakers, authors, course directors, planners, peer reviewers, and/or relevant staff are provided with this activity.

Presentations that provide information in whole or in part related to non FDA approved uses of drugs and/or devices will disclose the unlabeled indications or the investigational nature of their proposed uses to the audience. Participants should refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. Participants should verify all information and data before treating patients or employing any therapies prescribed in this educational activity. The opinions expressed in the educational activity are those of the presenting faculty and do not necessarily represent the views of PRIME®, the ACCME, AANP, ACPE, ANCC and other relevant accreditation bodies.

Content validation methods are consistently utilized by PRIME® to ensure that all program content is evidence-based, fair-balanced, and developed with scientific rigor and integrity. All clinical recommendations are based on evidence accepted within the medical profession. All scientific research referred to, reported or used to support a clinical recommendation conforms to accepted standards of experimental design, data collection and analysis. In addition to review of content by course directors and expert faculty, content is also validated through independent peer reviewers selected for their expertise in the content area, as well as their experience in the intended audience. All peer reviewers, planners, course directors, faculty and relevant staff utilized by PRIME® complete disclosures which are related to their role in the educational activity.

Accessibility

PRIME®is committed to providing access to our CME programs for individuals with disabilities as identified in Section 508 of the Rehabilitation Act for all web-based programs. This website is 508 compliant.

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Post-Test & Evaluation

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Clinician & Consumer Summaries on ACEIs and ARBs for Hypertension

Download these free summaries for your reference and/or patient handouts. You may also order bulk copies free of charge from the AHRQ Publication Clearinghouse below.

AHRQ Clearinghouse Bulk Order Form

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  • Alternatively, you can call the AHRQ Publications Clearinghouse at 1-800-358-9295. Reference the title and product number above.