Document Detail


Blood pressure-dependent and independent effects of agents that inhibit the renin-angiotensin system.
MedLine Citation:
PMID:  17414657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the blood pressure-dependent and independent effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) on major cardiovascular events. METHODS: Using data from 26 large-scale trials comparing an ACEI or an ARB with placebo or another drug class, meta-regression analyses were conducted in which treatment-specific relative risks for major cause-specific outcomes [stroke, major coronary heart disease (CHD) events and heart failure] were regressed against follow-up blood pressure differences. RESULTS: From a total of 146 838 individuals with high blood pressure or an elevated risk of cardiovascular disease, 22 666 major cardiovascular events were documented during follow-up. The analyses showed comparable blood pressure-dependent reductions in risk with ACEI and ARB (P >or= 0.3 for all three outcomes). The analyses also showed that ACEI produced a blood pressure-independent reduction in the relative risk of CHD of approximately 9% (95% confidence interval 3-14%). No similar effect was detected for ARB, and there was some evidence of a difference between ACEI and ARB in this regard (P = 0.002). For both stroke and heart failure there was no evidence of any blood pressure-independent effects of either ACEI or ARB. CONCLUSION: There are similar blood pressure-dependent effects of ACEI and ARB for the risks of stroke, CHD and heart failure. For ACEI, but not ARB, there is evidence of blood pressure-independent effects on the risk of major coronary disease events.
Authors:
; F Turnbull; B Neal; M Pfeffer; J Kostis; C Algert; M Woodward; J Chalmers; A Zanchetti; S MacMahon
Related Documents :
22481227 - Asynchrony, neural drive, ventilatory variability and comfort: nava versus pressure sup...
15369127 - Strategies for prevention and management of hypertension throughout life.
10981087 - The hypertension optimal treatment study: what did it give us?
19934107 - Tumour necrosis factor {alpha} blockade reduces circulating n-terminal pro-brain natriu...
2450247 - Effects of pimobendan (ud-cg 115) on the contractile function of the normal and "postis...
17587417 - Directly measured cabin pressure conditions during boeing 747-400 commercial aircraft f...
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  25     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-06-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  951-8     Citation Subset:  IM    
Affiliation:
George Institute for International Health, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia. fturnbull@george.org.au
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angiotensin II Type 1 Receptor Blockers / pharmacology*,  therapeutic use
Angiotensin-Converting Enzyme Inhibitors / pharmacology*,  therapeutic use
Blood Pressure / drug effects*
Cardiovascular Diseases / prevention & control*
Humans
Randomized Controlled Trials as Topic
Renin-Angiotensin System / drug effects*
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors
Comments/Corrections
Erratum In:
J Hypertens. 2007 Jul;25(7):1524

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Putting blood pressure in its place.
Next Document:  Does self-reported history of hypertension predict cardiovascular death? Comparison with blood press...