A metaanalysis of 43 randomized clinical trials (in 11,281 patients) comparing ARBs with placebo, drugs in other antihy- pertensive classes, and other ARBs found comparable blood pres- sure reductions for all ARBs; response rates were 48% to 55% (1, 4). The results of these trials suggest that candesartan, irbesartan, and telmisartan be slightly more effective than losartan.
ADVERSE REACTIONS In general, the ARBs are well tolerated. None of the drugs reviewed has a specific, dose-dependent adverse effect. Because cough is seen as a class effect of ACE inhibitors, studies with ARBs have specifically addressed this concern. The frequency of cough has been significantly lower in patients taking ARBs than in patients taking lisinopril (5). table 3 reviews the adverse reactions that have occurred in at least 2% of patients All of the ARBs are pregnancy category C for the first tri- mester and category D for the second and third trimesters.