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All Journal Journal of Applied Geospatial Information JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) 2-TRIK: TUNAS-TUNAS RISET KESEHATAN BENING Open Access Indonesian Journal of Medical Reviews Global Health Science (GHS) Journal Of Human And Education (JAHE) Formosa Journal of Science and Technology (FJST) Generics: Journal of Research in Pharmacy JOMPA ABDI: Jurnal Pengabdian Masyarakat Jurnal Pengabdian Masyarakat Bhinneka Perigel: Jurnal Penyuluhan Masyarakat Indonesia Termometer: Jurnal Ilmiah Ilmu Kesehatan Dan Kedokteran Indonesian Journal of Advanced Research (IJAR) Jurnal Kesehatan Farmasi Jurnal Pengabdian Masyarakat Bangsa Jurnal Anestesi: Jurnal Ilmu Kesehatan dan Kedokteran JUKEJ: Jurnal Kesehatan Jompa Jurnal Ventilator: Jurnal Riset Ilmu Kesehatan dan Keperawatan PEDAMAS (Pengabdian Kepada Masyarakat) Jurnal Pendekar Nusantara Natural: Jurnal Pelaksanaan Pengabdian Bergerak Bersama Masyarakat Generics : Journal of Research in Pharmacy Bhakti Sabha Nusantara Journal of Health Research and Technology Karya Kesehatan Journal of Community Engagement International Journal Of Health And Social Behavior International Journal of Health and Medicine Masyarakat: Jurnal Pengabdian Media Pengabdian Kesehatan Indonesia Jurnal Kesehatan Lentera Aisyiyah Jurnal Riset dan Pengabdian Interdisipliner Jurnal Pengabdian Ilmu Kesehatan
Fifin Oktaviani
Pharmacy Study Program, Faculty Of Health Sciences, Universitas Batam, Batam, Indonesia
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Blood Pressure-Lowering Effects of ACEI+CCB versus ARB+CCB Combination Therapy in Hypertensive Patients: A Systematic Review Kartini Hasballah; Zaki Mubarak; Fifin Oktaviani
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 1 (2025): Januari : Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i1.7130

Abstract

Background: Hypertension affects more than 1.2 billion adults worldwide, and most patients require at least two drugs to reach their blood pressure (BP) target. Current guidelines recommend a renin–angiotensin system (RAS) blocker plus a calcium channel blocker (CCB), but do not specify whether the RAS component should be an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB). Objective: To compare the BP-lowering effects of ACEI+CCB and ARB+CCB in adults with hypertension, including target attainment, tolerability, cardiovascular outcomes, and cost. Methods: We followed PRISMA 2020 and searched PubMed, ScienceDirect, Google Scholar, and Garuda for reports published from 2020 to 2025, with additional citation searching. Eligibility was defined using PICOS. Risk of bias was assessed with RoB 2, AMSTAR 2, and Joanna Briggs Institute checklists, and findings were synthesized narratively following SWiM guidance. Results: Eight of 535 records were included: one network meta-analysis, one outcome trial, three systematic reviews, and three observational or comparative studies. Both combinations produced substantial reductions in systolic and diastolic BP. ARB+CCB ranked highest for BP reduction in chronic kidney disease, while an Indonesian cohort reported target attainment of 48.9% with amlodipine–candesartan and 45.2% with amlodipine–ramipril. ARB-based regimens caused less cough and angioedema, whereas ACEI co-therapy better offset CCB-related oedema. Conclusion: No clinically meaningful difference in BP lowering was found between combinations. Choice should consider tolerability, comorbidity, cardiovascular evidence, and cost; head-to-head trials in Indonesian patients are needed.    
Co-Authors Agustina, Nurul Albasithu, M Farhan Aldhehita Ari Kusumawati Aldhehita Ari Kusumawati Aldhehita Ari Kusumawati Alysa Dwirini Andini Putri Cecep Kusmana Djoko Wahyono Djoko Wahyono Dwi Ratna Fitriyani Elfasyari, Trie Yuni Endang Yuniarti Fendi Hidayat Hamid, Hazrina Binti Helda Muliana Heldi Candra Heldi Candra Heldi Candra Hidayati Hidayati Hidayati Hidayati Hidayati Hilda Muliana Hilda Muliana Ika Novita Sari Isramilda, Isramilda Istiqomah, Iffah Nur Kartini Hasballah Kurnia, Claudia Angelina Kusumawati, Aldhehita Ari Lita Riastienanda Putri Lita Riastienanda Putri Marsyanda Azzahra Rizqy Mukhamad Najib Mursal Nasya Efrilianda Putri Nisa Andryani Nadapdap Nugrahani, Andita Nursyidah, Nursyidah Putri Meisa Anggesta Rizki Yuli Sari Satria, Mohd Rhana Sri Nova Deltu Sri Nova Deltu Sri Nova Deltu Suci Wahyuliza Ulinnuha, Anisa Wilda Fasim Hasibuan Wilda Fasim Hasibuan Yoga Fitriana Yundelfa, Mandria Zaki Mubarak