Journal of the American Society of Hypertension
Volume 1, Issue 4 , Pages 286-294 , July 2007

Angiotensin receptor blockers vs. angiotensin converting enzyme inhibitors and acute coronary syndrome outcomes in elderly patients: a population-based cohort study (UMPIRE study results)

  • Subodh Verma, MD, PhD, FRCSC

      Affiliations

    • Division of Cardiac Surgery, St. Michael’s Hospital, University of Toronto, Toronto, Canada
    • Kennan Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, University of Toronto, Toronto, Canada
    • Corresponding Author InformationCorresponding author: Subodh Verma, MD, PhD, FRCSC, Division of Cardiac Surgery, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada M5B 1W8. Tel: 416-864-5303; fax: 416-782-0096.
  • ,
  • Muhammad M. Mamdani, PharmD, MA, MPH

      Affiliations

    • Institute for Clinical Evaluative Sciences, Toronto, Canada
    • Kennan Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, University of Toronto, Toronto, Canada
  • ,
  • Mohammed Al-Omran, MD, MSc

      Affiliations

    • Division of Vascular Surgery, Toronto General Hospital, University of Toronto, Toronto, Canada
  • ,
  • Magda Melo, BScPhm, MSc

      Affiliations

    • Institute for Clinical Evaluative Sciences, Toronto, Canada
    • Kennan Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, University of Toronto, Toronto, Canada
  • ,
  • Jean L. Rouleau, MD

      Affiliations

    • Division of Cardiology, University of Montreal, Montreal, Canada

Received 6 April 2007 ,Accepted 15 May 2007.

References 

  1. Dzau V. The cardiovascular continuum and renin-angiotensin-aldosterone system blockade. J Hypertens Suppl. 2005;23(Suppl 1):S9–S17
  2. Strauss MH, Hall AS. Angiotensin receptor blockers may increase risk of myocardial infarction: unraveling the ARB-MI paradox. Circulation. 2006;114:838–854
  3. McMurray J, Solomon S, Pieper K, Reed S, Rouleau J, Velazquez E, et al. The effect of valsartan, captopril, or both on atherosclerotic events after acute myocardial infarction: an analysis of the Valsartan in Acute Myocardial Infarction Trial (VALIANT). J Am Coll Cardiol. 2006;47:726–733
  4. Levy AR, O’Brien BJ, Sellors C, Grootendorst P, Willison D. Coding accuracy of administrative drug claims in the Ontario Drug Benefit database. Can J Clin Pharmacol. 2003;10:67–71
  5. Rubin DB, Thomas N. Matching using estimated propensity scores: relating theory to practice. Biometrics. 1996;52:249–264
  6. Rosenbaum PR, Rubin DB. Reducing bias in observational studies using subclassification on the propensity score. J Am Stat Assoc. 1984;79:516–524
  7. Austin PC, Daly PA, Tu JV. A multi-center study of the coding accuracy of hospital discharge administrative data for patients admitted to cardiac care units in Ontario. Am Heart J. 2002;144:290–296
  8. Cox JL, Melady MP, Chen E, Naylor CD. Towards improved coding of acute myocardial infarction in hospital discharge abstracts: a pilot project. Can J Cardiol. 1997;13:351–358
  9. Schneeweiss S, Seeger JD, Maclure M, Wang PS, Avorn J, Glynn RJ. Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data. Am J Epidemiol. 2001;154:854–864
  10. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. Lancet. 1993;342:821–828
  11. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325:293–302
  12. Kober L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K, et al. Trandolapril Cardiac Evaluation (TRACE) Study Group A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 1995;333:1670–1676
  13. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342:145–153
  14. Fox KM. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA Study). Lancet. 2003;362:782–788
  15. Dagenais GR, Pogue J, Fox K, Simoons ML, Yusuf S. Angiotensin-converting-enzyme inhibitors in stable vascular disease without left ventricular systolic dysfunction or heart failure: a combined analysis of three trials. Lancet. 2006;368:581–588
  16. Teo K, Yusuf S, Sleight P, et al. Rationale, design, and baseline characteristics of two large, simple, randomized trials evaluating telmisartan, ramipril, and their combination in high-risk patients: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND) trials. Am Heart J. 2004;148:52–61
  17. Levy BI. Can angiotensin II type 2 receptors have deleterious effects in cardiovascular disease? (Implications for therapeutic blockade of the renin-angiotensin system). Circulation. 2004;109:8–13
  18. Nakajima M, Hutchinson HG, Fujinaga M, Hayashida W, Morishita R, Zhang L, et al. The angiotensin II type 2 (AT2) receptor antagonizes the growth effects of the AT1 receptor: gain-of-function study using gene transfer. Proc Natl Acad Sci U S A. 1995;92:10663–10667
  19. Julius S, Kjeldsen SE, Weber M, Brunner HR, Ekman S, Hansson L, et al. VALUE trial group Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomized trial. Lancet. 2004;363:2022–2031
  20. Dickstein K, Kjekshus J. Effects of losartan and captopril on mortality and morbidity in high-risk patients after acute myocardial infarction: the OPTIMAAL randomized trial (Optimal Trial in Myocardial Infarction with Angiotensin II Antagonist Losartan). Lancet. 2002;360:752–760
  21. Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJ, et al. CHARM Investigators and Committees Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362:777–781
  22. Granger CB, McMurray JJ, Yusuf S, Held P, Michelson EL, Olofsson B, et al. CHARM Investigators and Committees Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative Trial. Lancet. 2003;362:772–776
  23. Parving HH, Lehnert H, Brochner-Mortensen J, Gomis R, Andersen S, Arner P. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. 2001;345:870–878
  24. Demers C, McMurray JJ, Swedberg K, Pfeffer MA, Granger CB, Olofsson B, et al. CHARM Investigators Impact of candesartan on nonfatal myocardial infarction and cardiovascular death in patients with heart failure. JAMA. 2005;294:1794–1798
  25. Epstein BJ, Gums JG. Angiotensin receptor blockers versus ACE inhibitors: prevention of death and myocardial infarction in high-risk populations. Ann Pharmacother. 2005;39:470–480
  26. Strippoli GF, Craig M, Deeks JJ, Schena FP, Craig JC. Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy: systematic review. BMJ. 2004;329:828
  27. Cheung BM, Cheung GT, Lauder IJ, Lau CP, Kumana CR. Meta-analysis of large outcome trials of angiotensin receptor blockers in hypertension. J Hum Hypertens. 2006;20:37–43
  28. McDonald MA, Simpson SH, Ezekowitz JA, Gyenes G, Tsuyuki RT. Angiotensin receptor blockers and risk of myocardial infarction: systematic review. BMJ. 2005;331:873
  29. Volpe M, Mancia G, Trimarco B. Angiotensin II receptor blockers and myocardial infarction: deeds and misdeeds. J Hypertens. 2005;23:2113–2118
  30. Verdecchia P, Angeli F, Gattobigio R, Reboldi GP. Do angiotensin II receptor blockers increase the risk of myocardial infarction?. Eur Heart J. 2005;26:2381–2386
  31. Strauss MH, Lonn EM, Verma S. Is the jury out? (Class specific differences on coronary outcomes with ACE-inhibitors and ARBs: insight from meta-analysis and The Blood Pressure Lowering Treatment Trialists’ Collaboration). Eur Heart J. 2005;26:2351–2353
  32. Bourgault C, Senecal M, Brisson M, Marentette MA, Gregoire JP. Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a Population-Based Study. J Hum Hypertens. 2005;19:607–613

 Conflict of interest: none.

PII: S1933-1711(07)00124-6

doi: 10.1016/j.jash.2007.05.003

Journal of the American Society of Hypertension
Volume 1, Issue 4 , Pages 286-294 , July 2007