| Blood pressure-dependent and independent effects of agents that inhibit the renin-angiotensin system. | |
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MedLine Citation:
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PMID: 17414657 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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; F Turnbull; B Neal; M Pfeffer; J Kostis; C Algert; M Woodward; J Chalmers; A Zanchetti; S MacMahon |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 25 ISSN: 0263-6352 ISO Abbreviation: J. Hypertens. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-06 Completed Date: 2007-06-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 951-8 Citation Subset: IM |
Affiliation:
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George Institute for International Health, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia. fturnbull@george.org.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin II Type 1 Receptor Blockers
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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:
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0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors |
| Comments/Corrections | |
Erratum In:
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J Hypertens. 2007 Jul;25(7):1524 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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