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ACEIs, ARBs, or DRI for Adults With Hypertension

• CME Information
• Faculty Biographies & Disclosures
• References
• Course Presentations
• CME Posttest

CME Information

Course Overview Educational Objectives Target Audience Method of Participation

Accreditation Statement Term of Approval Peer Review Program Director

Disclaimer Disclosure Acknowledgement of Support

Course Overview

Among the many choices in antihypertensive therapy are those aimed at inhibiting or blocking the renin-angiotensin system (RAS). A systematic review of 110 clinical studies published between 1988 and December 2010 sought to determine the comparative effectiveness, benefits, and adverse effects of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and direct renin inhibitors (DRIs) for adults with hypertension. The report does not review studies comparing individual drugs within each class or evidence about using these drugs for congestive heart failure or diabetic kidney disease. This CME activity is provided to assist in decisionmaking along with a patient’s values and preferences. This activity should not be construed to represent clinical recommendations or guidelines. The full report, listing all studies, is available at http://www.effectivehealthcare.ahrq.gov/acearbhbp.cfm.

Educational Objectives

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

• Differentiate how ACEIs, ARBs, and direct renin inhibitors differ in blood pressure control, cardiovascular risk reduction, cardiovascular events, quality of life and other outcomes for adult patients with essential hypertension.
• Identify how ACEIs, ARBs, and direct renin inhibitors differ in safety, adverse events, tolerability, persistence with drug therapy, and treatment adherence for adult patients with essential hypertension.

Target Audience

This CME activity is designed to meet the educational needs of primary care and internal medicine physicians, as well as other healthcare professionals who treat patients with hypertension.

Method of Participation

This activity is in PowerPoint file format and is accompanied by talking points and references linked to PubMed abstracts.

To receive a maximum of 1.0 AMA PRA Category 1 Credit(s)™ you should:

• View the presentations in this enduring material.
• Complete the posttest (you must answer 6 out of 8 questions correctly).
• Complete and submit the CME registration and evaluation forms.

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

Hardware/software requirements: Activities should be run with recent versions of common browsers, including Internet Explorer, Firefox, and Google Chrome.

If you have questions about the participation process, please e-mail the Office of Continuing Medical Education, cme@bcm.edu or phone 713.798.8237.

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.    

Term of Approval

October 2011 through October 2014. Original release date: October 2011

Peer Review

In September 2011,  this continuing medical education online enduring material was reviewed by Addison A. Taylor, MD, PhD, Professor of Medicine, Pharmacology, and Molecular Physiology and Biophysics and Director, Division of Hypertension and Clinical Pharmacology, Baylor College of Medicine, Houston, Texas. To ensure the continued scientific relevance of this enduring material, its content will be reviewed again in October 2014.

Disclosures: Non-public support of research – Novartis Pharmaceuticals, Inc.; speakers bureau – Novartis Pharmaceuticals, Inc. (resigned 12/2010); honorarium recipient – Novartis Pharmaceuticals, Inc. (none received since 12/2010).

Program Director

Michael Fordis, MD
Sr. Associate Dean
Director, Center for Collaborative and Interactive Technologies
Director, John M. Eisenberg Center for Clinical Decisions and Communications Science
Baylor College of Medicine
Houston, Texas

Disclosures: Nothing to disclose.

Disclaimer

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

Disclosure

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support ^SM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Vijay Nambi, MD, Contributor:   Non-public support of research – Gillson Logenbaugh Foundation, Gulf Coast Regional Foundation, Cytokinetics Research Collaboration (no financial support) from GE, Medipattern, Tomtec; co-investigator on studies sponsored by: Regeneron, AstraZeneca, Merck, Esperion, Genentech, Novartis, GlaxoSmithKline, Bristol Myers Squibb, Amarin, Roche, and Abbott; advisory committee member for Roche and Anthera Pharmaceuticals (National monitor for a study).

Addison Taylor, MD, PhD, Peer Reviewer: Non-public support of research – Novartis Pharmaceuticals, Inc.; speakers bureau – Novartis Pharmaceuticals, Inc. (resigned 12/2010); honorarium recipient – Novartis Pharmaceuticals, Inc. (none received since 12/2010).

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

Michael Fordis, MD, Activity Director: Nothing to disclose.
Andrea D. Humphries, PhD, Medical Writer: Nothing to disclose.
Gillian D. Sanders Schmidler, PhD, Contributor: Nothing to disclose.

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

Acknowledgement of Support

This CME activity is supported by a contract, HHSA290200810015C, from the Agency for Healthcare Research and Quality.

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