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Preadmission use of renin–angiotensin blockers and rupture of abdominal aortic aneurysm: a nationwide, population‐based study
Author(s) -
Wemmelund Holger,
Høgh Annette,
Hundborg Heidi H.,
Johnsen Søren P.,
Lindholt Jes S.
Publication year - 2016
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3913
Subject(s) - medicine , abdominal aortic aneurysm , pharmacoepidemiology , cardiology , aneurysm , surgery , pharmacology , medical prescription
Purpose Rupture of abdominal aortic aneurysms (rAAA) is associated with high mortality. Use of angiotensin converting enzyme inhibitors (ACE‐inhibitors) and angiotensin receptor blockers (ARBs) has been suggested to reduce the risk of rAAA. This nationwide, combined case–control and follow‐up study aims to examine the possible impact of preadmission renin–angiotensin system blockade on the risk of rAAA and case fatality following rAAA. Methods Using Danish healthcare registries, a combined case–control and follow‐up study was conducted among all patients with a first‐time hospital admission for rAAA and AAA controls without rupture in Denmark from 1996 to 2012. Individual‐level data were obtained on preadmission drug use, comorbidity, socioeconomic factors, healthcare services use, and death. Results The adjusted age‐matched and sex‐matched odds ratios (adj. OR) were 0.96 (95% confidence interval (CI): 0.85; 1.07) for rAAA for current ACE‐inhibitor users and 0.93 (95%CI: 0.79; 1.09) for current ARB users compared with never users. Propensity score‐matched analyses yielded similar results for current ACE‐inhibitor users (adj. OR: 1.02, 95%CI: 0.88; 1.19) and current ARB users (adj. OR: 1.02, 95%CI: 0.83; 1.26). The total 30‐day mortality rate after hospital admission was 61.0% in current ACE‐inhibitor users compared with 59.4% in non‐ACE‐inhibitor users (adjusted mortality rate ratio (adj. MRR) 1.06, 95%CI: 0.94; 1.20) and 58.6% in current ARB users compared with 59.9% in non‐ARB users (adj. MRR: 0.96, 95%CI: 0.82; 1.14). Conclusion Use of renin–angiotensin system blockade was not associated with a lower risk of rAAA or lower case fatality following rAAA. Copyright © 2015 John Wiley & Sons, Ltd.