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ace inhibitors vs arb

Takayuki Ishida, Akinori Oh, Shinzo Hiroi, Yukio Shimasaki, Takuya Tsuchihashi
AIM: To analyze the current use of antihypertensive drug classes in Japanese hypertensive patients stratified by age, highlighting differences between older and younger patients. METHODS: A nationwide medical database was used to evaluate antihypertensive use in patients (aged ≥20 years) who had received a prescription for one or more antihypertensive drug as an outpatient from April 2014 to March 2015. Patients (n = 59 867) were age-stratified into three groups: <65 years (28...
March 6, 2018: Geriatrics & Gerontology International
Ki Hong Choi, Ga Yeon Lee, Jin-Oh Choi, Eun-Seok Jeon, Hae-Young Lee, Hyun-Jai Cho, Sang Eun Lee, Min-Seok Kim, Jae-Joong Kim, Kyung-Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok-Min Kang, Dong-Ju Choi, Byung-Su Yoo, Kye Hun Kim, Hyun-Young Park, Myeong-Chan Cho, Byung-Hee Oh
BACKGROUND: After introduction of up-titration strategy, there are limited data on comparison between the effects of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocker (ARB) in patients with heart failure with reduced ejection fraction (HFrEF). The study sought to investigate the association between treatment with ARB at discharge and clinical outcomes in patients with HFrEF compared with treatment with ACEI or no renin angiotensin system blocker (RASB). METHODS: The KorAHF registry is a prospective multicenter cohort and included patients who were hospitalized for acute heart failure (AHF)...
April 15, 2018: International Journal of Cardiology
J Liu, W Wang, J Liu, Y Wang, Y Qi, J Y Sun, D Zhao
Objective: To evaluate the impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome (ACS). Methods: This multi-center cross-sectional study collected data from 34 hospitals covering 22 provinces in China. Hospitals were randomly divided into four groups: control group(routine treatment and care), promotional calendar group (routine treatment and care plus giving propaganda desk calendar to patients), education group (routine treatment and care add patients education by nurses) and combined intervention group (promotional calendar and education)...
February 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Tetsuo Yamaguchi, Takeshi Kitai, Takamichi Miyamoto, Nobuyuki Kagiyama, Takahiro Okumura, Keisuke Kida, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Junji Yamaguchi, Takamasa Iwai, Sadahiro Hijikata, Ryo Masuda, Ryoichi Miyazaki, Nobuhiro Hara, Yasutoshi Nagata, Toshihiro Nozato, Yuya Matsue
Guideline-directed medical therapy (GDMT) is recommended for patients with heart failure with reduced ejection fraction (HFrEF). However, the prognostic impact of medication optimization at the time of discharge in patients hospitalized with heart failure (HF) is unclear. We analyzed 534 patients (73 ± 13 years old) with HFrEF. The status of GDMT at the time of discharge (prescription of angiotensin converting enzyme inhibitor [ACE-I]/angiotensin receptor blocker [ARB] and β blocker [BB]) and its association with 1-year all-cause mortality and HF readmission were investigated...
February 21, 2018: American Journal of Cardiology
Elizabeth do Espirito Santo Cestário, Letícia Aparecida Barufi Fernandes, Luiz Tadeu Giollo-Júnior, Jéssica Rodrigues Roma Uyemura, Camila Suemi Sato Matarucco, Manoel Idelfonso Paz Landim, Luciana Neves Cosenso-Martin, Lúcia Helena Bonalume Tácito, Heitor Moreno, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo
BACKGROUND: Resistant hypertension is characterized when the blood pressure (BP) remains above the recommended goal after taking three antihypertensive drugs with synergistic actions at their maximum recommended tolerated doses, preferably including a diuretic. Identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether acting on the control of intravascular volume or sodium balance, or acting on the effects of the renin-angiotensin-aldosterone system (RAAS) on the kidney...
February 12, 2018: Trials
N P G Hoedemaker, P Damman, J P Ottervanger, J H E Dambrink, A T M Gosselink, E Kedhi, E Kolkman, R J de Winter, A W J van 't Hof
Aims: Optimal medical therapy (OMT) is recommended in acute coronary syndrome (ACS) patients. Few studies present temporal trends of OMT prescription and its impact on outcomes in a real-world setting. We aimed to evaluate OMT prescription in a real-world ACS population and its relation to mortality during almost a decade. Methods and results: Consecutive STEMI and NSTEMI patients (n = 9202) admitted to a single Dutch tertiary hospital between 2006-2014 were included and followed for drug prescription and mortality up to 1 year...
January 30, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Robin Mathews, William Wang, Lisa A Kaltenbach, Laine Thomas, Rashmee U Shah, Murtuza Ali, Eric D Peterson, Tracy Y Wang
Background -Medication adherence is important to improve long-term outcomes after acute myocardial infarction (MI). We hypothesized that there is significant variation among United States (U.S.) hospitals in terms of post-MI medication adherence, and that patients treated at hospitals with higher post-MI medication adherence will have better long-term cardiovascular outcomes. Methods -We identified 19,704 Medicare patients discharged after acute MI from 347 U.S. hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) from 1/2/2007 to 10/1/2010...
January 31, 2018: Circulation
Gregory Charak, Benjamin A Kuritzkes, Ahmed Al-Mazrou, Kunal Suradkar, Neda Valizadeh, Steven A Lee-Kong, Daniel L Feingold, Emmanouil P Pappou
PURPOSE: Diverting ileostomies help prevent major complications related to anastomoses after colorectal resection but can cause metabolic derangement and hypovolemia, leading to readmission. This paper aims to determine whether angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) use increased the risk of readmission, or readmission specifically for dehydration after new ileostomy creation. METHODS: Retrospective analysis of patients undergoing diverting ileostomy at a tertiary-care hospital, 2009-2015...
January 27, 2018: International Journal of Colorectal Disease
Chen-Yu Huang, Yao-Hsu Yang, Lian-Yu Lin, Chia-Ti Tsai, Juey-Jen Hwang, Pau-Chung Chen, Jiunn-Lee Lin
OBJECTIVES: Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) is associated with increased mortality, mainly mediated by increased thromboembolic events and progressive heart failure. Many studies suggested inhibition of renin-angiotensin-aldosterone system (RAAS) could reduce new AF in various clinical conditions. However, evidence concerning the effects of RAAS inhibitors on AF prevention remains unclear in HCM. Our study is to investigate whether treatment with ACE inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) could lower the risk of new AF in HCM...
January 25, 2018: Heart: Official Journal of the British Cardiac Society
Martin H Strauss, Alistair S Hall
The renin angiotensin aldosterone system (RAAS) plays a central role in the pathophysiology of hypertension and vascular disease. Angiotensin-converting enzyme inhibitors (ACEi's) suppress angiotensin II (ANG II) concentrations, whereas angiotensin II type 1 (AT1) receptor blockers (ARBs) block the binding of ANG II to AT1 receptors. ACEi's and ARBs are both effective antihypertensive agents and produce similar risk reductions for stroke, a blood pressure-dependent phenomenon. ACEi's also reduce the risk for myocardial infarction (MI) and all-cause mortality in high-risk hypertensive patients as well as in people with diabetes, vascular disease and congestive heart failure...
December 22, 2017: Canadian Journal of Diabetes
Naoki Masaki, Shunsuke Kawamoto, Naotaka Motoyoshi, Osamu Adachi, Kiichiro Kumagai, Satoshi Kawatsu, Yukihiro Hayatsu, Shintaro Katahira, Katsuhiro Hosoyama, Masatoshi Akiyama, Yoshikatsu Saiki
PURPOSE: The Cox maze IV (CMIV) procedure is being used increasingly frequently for surgical ablation of atrial fibrillation (AF). This study aimed to identify the risk factors of the need for postoperative pacemaker implantation (PMI) after CMIV. METHODS: Preoperative, intraoperative, and postoperative data were retrospectively collected from 67 consecutive patients who underwent CMIV at our institution; 7 (10.4%) required PMI (as a treatment of brady AF or sick sinus syndrome)...
December 16, 2017: Surgery Today
Masanori Suzuki, Yuya Matsue, Sayaka Izumi, Ayako Kimura, Tomoaki Hashimoto, Kentaro Otomo, Hiroshi Saito, Makoto Suzuki, Yasuhisa Kato, Ryohkan Funakoshi
We evaluated the impact of pharmacist-led heart failure (HF) drug recommendations during hospitalization for hospitalized patients with HF. Hospitalized patients with HF were retrospectively reviewed. Patients were hospitalized before (n = 208, non-intervention group) or after (n = 170, intervention group) the launch of the HF multidisciplinary team (HFMDT) approach with pharmacist-led HF medication optimization. There were no significant group differences in patient background characteristics at admission...
December 4, 2017: Heart and Vessels
Carlos de Diego, Luis González-Torres, José María Núñez, Raúl Centurión Inda, David A Martin-Langerwerf, Antonio D Sangio, Piotr Chochowski, Pilar Casasnovas, Julio C Blazquéz, Jesús Almendral
BACKGROUND: Angiotensin-neprilysin inhibition compared to angiotensin inhibition decreased sudden cardiac death in patients with reduced ejection fraction heart failure (rEFHF). The precise mechanism remains unclear. OBJECTIVE: The purpose of this study was to explore the effect of angiotensin-neprilysin inhibition on ventricular arrhythmias compared to angiotensin inhibition in rEFHF patients with an implantable cardioverter-defibrillator (ICD) and remote monitoring...
March 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Noemi Pavo, Georg Goliasch, Raphael Wurm, Johannes Novak, Guido Strunk, Mariann Gyöngyösi, Marko Poglitsch, Marcus D Säemann, Martin Hülsmann
BACKGROUND: Blockade of the renin-angiotensin system (RAS) represents a main strategy in the therapy of heart failure with reduced ejection fraction (HFrEF), but the role of active renin concentration (ARC) for guiding therapy in the presence of an RAS blockade remains to be established. This study assessed angiotensin profiles of HFrEF patients with distinct RAS activations as reflected by ARC. METHODS: Two cohorts of stable chronic HFrEF patients on optimal medical treatment (OMT) were enrolled...
November 14, 2017: Clinical Chemistry
Tomoki Ochiai, Shigeru Saito, Futoshi Yamanaka, Koki Shishido, Yutaka Tanaka, Tsuyoshi Yamabe, Shinichi Shirai, Norio Tada, Motoharu Araki, Toru Naganuma, Yusuke Watanabe, Masanori Yamamoto, Kentaro Hayashida
OBJECTIVE: The persistence of left ventricular (LV) hypertrophy is associated with poor clinical outcomes after transcatheter aortic valve implantation (TAVI) for aortic stenosis. However, the optimal medical therapy after TAVI remains unknown. We investigated the effect of renin-angiotensin system (RAS) blockade therapy on LV hypertrophy and mortality in patients undergoing TAVI. METHODS: Between October 2013 and April 2016, 1215 patients undergoing TAVI were prospectively enrolled in the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVI registry...
October 6, 2017: Heart: Official Journal of the British Cardiac Society
Sandra Wagner, Marie Metzger, Martin Flamant, Pascal Houillier, Jean-Philippe Haymann, François Vrtovsnik, Eric Thervet, Jean-Jacques Boffa, Ziad A Massy, Bénédicte Stengel, Patrick Rossignol
BACKGROUND: Low and high blood potassium levels are common and were both associated with poor outcomes in patients with chronic kidney disease (CKD). Whether such relationships may be altered in CKD patients receiving optimized nephrologist care is unknown. METHODS: NephroTest is a hospital-based prospective cohort study that enrolled 2078 nondialysis patients (mean age: 59 ± 15 years, 66% men) in CKD stages 1 to 5 who underwent repeated extensive renal tests including plasma potassium (PK) and glomerular filtration rate (GFR) measured (mGFR) by (51)Cr-EDTA renal clearance...
September 12, 2017: BMC Nephrology
S V Nedogoda, A O Konradi, N E Zvartau, E V Chumachek, A A Ledyaeva, V V Tsoma, A S Salasyuk, J S Judina, V O Smirnova, V J Khripaeva, R V Palashkin
The aim of the study was to assess the possibility of fixed combination perindopril+amlodipine to improve arterial elesticity in patients with hypertension and high pulse wave velocity, despite previous combination antihypertensive therapy. In an open, multicenter, observational study duration of 24 weeks 80 patients were included, divided into 4 equal-sized groups, depending on initial antihypertensive therapy: Group 1 - the combination of ACE inhibitor and diuretic, Group 2 - the combination of ACE inhibitor and calcium channel blocker, Group 3 - the combination of diuretic and angiotensin receptor blocker, Group 4 - the combination of angiotensin receptor blocker and calcium antagonist...
March 2017: Kardiologiia
Marina Amaral de Ávila Machado, Cristiano Soares de Moura, Yishu Wang, Coraline Danieli, Michal Abrahamowicz, Sasha Bernatsky, Hassan Behlouli, Louise Pilote
The authors compared the effectiveness of thiazide diuretic (TD), angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), and calcium channel blocker (CCB) monotherapies for the treatment of nondiabetic hypertension using MarketScan Databases 2010-2014. Multivariable Cox regression models assessed whether the addition of a new antihypertensive drug, treatment discontinuation, or switch and major cardiovascular or cerebrovascular events varied across groups. A total of 565 009 patients started monotherapy with ACEIs (43...
October 2017: Journal of Clinical Hypertension
Jenny I Shen, Anjali B Saxena, Sitaram Vangala, Satvinder K Dhaliwal, Wolfgang C Winkelmayer
BACKGROUND: Although angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB) have been shown to preserve residual kidney function in a select group of Asian patients undergoing continuous ambulatory peritoneal dialysis (PD) in two small randomized clinical trials, the effectiveness of these drugs has yet to be demonstrated in a more diverse population of patients with multiple comorbid conditions. We investigated the association between ACEI/ARB use and development of recorded anuria in a cohort of patients initiating PD in the U...
June 17, 2017: BMC Nephrology
Shreya J Shah, Randall S Stafford
BACKGROUND: To examine current patterns of hypertension (HTN) treatment in the United States, including blood pressure (BP) control, prevalence of different antihypertensive agents, and variations in treatment associated with patient and physician characteristics. METHODS: We used data from the National Disease and Therapeutic Index (NDTI), a nationally representative physician survey produced by QuintilesIMS. We selected patients with a diagnosis of HTN and identified those prescribed antihypertensive therapies...
October 1, 2017: American Journal of Hypertension
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