HEDIS: The Difference Between ACE and ARBCompanies are getting ready for HEDIS (Healthcare Effectiveness Data and Information Set). Trainings are being scheduled. Tools are being updated. Cheat sheets are being shared.

In all this sharing, one of my coworkers sent me a nice updated list of ACEs and ARBs (for HEDIS measure Comprehensive Diabetic Care – Nephropathy Screening). 

I tried and tried to remember the difference between an ACE and an ARB. Eventually, I gave up… I just couldn’t remember.

Since I had to look it up and refresh myself, I thought it might be nice to share.

ACE

ACE stands for angiotensin-converting enzyme. The medication is an ACE inhibitor. ACE inhibitors have two functions. They decrease the amount of sodium retained in the kidneys and stop (inhibit) the production of a hormone called angiotensin II. This hormone causes blood vessels to narrow.

When angiotensin II isn’t produced, blood vessels relax and expand. This lowers blood pressure, slows the progression of kidney disease due to better blood flow and reduces the risk of atherosclerosis by relaxing blood vessels.

Common ACE inhibitors include:

  • Aceon® (Perindopril)
  • Accupril® (quinapril)
  • Accuretic® (quinapril/HCTZ)
  • Altace® (ramipril)
  • Benazepril
  • Capoten® (captopril)
  • Capozide® (captopril/HCTZ)
  • Captopril
  • Enalapril
  • Fosinopril
  • Lexxel® (enelapril/felodipine)
  • Lisinopril
  • Lotensin® (benazepril)
  • Lotrel® (amlodipine/benazepril)
  • Mavik® (trandolapril)
  • Moexipril
  • Monopril® (fosinopril)
  • Monopril HCT® (fosinopril/HCTZ)
  • Perindopril
  • Prinivil® (lisinopril)
  • Quinapril
  • Ramipril
  • Tarka® (trandolapril/HCTZ)
  • Trandolipril
  • Uniretic® (moexipril/HCTZ)
  • Univasc® (moexipril)
  • Vaseretic® (enalapril/HCTZ)
  • Vasotec® (enalapril)
  • Zestoretic® (lisinopril/HCTZ)
  • Zestril® (lisinopril)

ARB

ARB stands for Angiotensin II Receptor Blocker. Angiotensin II is a chemical produced in the blood system that causes muscles surrounding blood vessels to contract. This increases pressure within the blood vessels causing increased blood pressure.

Angiotensin II receptor blockers (ARBs) are medications that block the action of angiotensin II by preventing it from binding to angiotensin II receptors. Blood vessels relax and dilate. This reduces the effects of heart failure as circulation is improved, slows the progression of kidney disease due to better blood flow and eases the damaging effects of hypertension. Angiotensin II receptor blockers also act on hormones that regulate sodium and water balance which in turn lowers blood pressure as well.

Since ARB medications have effects similar to those of ACE inhibitors, they often only are used when ACE inhibitors are not tolerated by patients. For example, ACE inhibitors can cause an annoying cough difficult for the patient to tolerate. Their doctor may choose to prescribe an ARB instead since they are less likely to cause a cough.

Some common ARBs are:

  • Atacand® (candesartan)
  • Atacand HCT® (candesartan/HCTZ)
  • Avalide® (irbesartan/HCTZ)
  • Avapro® (irbesartan)
  • Azor® (olmesartan/amlodipine)
  • Benicar® (olmesartan)
  • Benicar HCT® (olmesartan/HCTZ)
  • Candesartan
  • Cozaar® (losartan)
  • Diovan® (valsartan/HCTZ)
  • Diovan HCT® (valsartan/amlodipine)
  • Eprosartan
  • Exforge® (valsartan/amlodipine)
  • Exforge HCT® (valsartan/HCTZ/amlodipine)
  • Hyzaar® (losartan/HCTZ)
  • Irbesartan
  • Losartan
  • Micardis® (telmisartan)
  • Micardis HCT® (telmisartan/HCTZ)
  • Olmesartan
  • Telmisartan
  • Teveten® (eprosartan)
  • Teveten HCT® (eprosartan/HCTZ)
  • Valsarta