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Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure.
Hypertens Res. 2010 Mar; 33(3):197-202.HR

Abstract

Large-scale, placebo-controlled, randomized clinical trials have shown that angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) reduce mortality and hospitalization in patients with heart failure (HF) caused by left ventricular systolic dysfunction (LVSD). However, it is unknown whether ACE inhibitors and ARBs have similar effects on the long-term outcomes in HF patients encountered in routine clinical practice. The Japanese Cardiac Registry of Heart Failure in Cardiology enrolled HF patients hospitalized with worsening symptoms and they were followed during an average of 2.2 years. The outcome data were compared in patients with LVSD by echocardiography (ejection fraction, EF <40%) according to the predischarge use of ACE inhibitors (n=356) or ARBs (n=372). The clinical characteristics were similar between patients with ACE inhibitor and ARB use, except for higher prevalence of hypertensive etiology and diabetes mellitus. There was no significant difference between ACE inhibitor and ARB use in all-cause death (adjusted hazard ratio 0.958, 95% confidence interval 0.601-1.527, P=0.858) and rehospitalization (adjusted hazard ratio 0.964, 95% confidence interval 0.683-1.362, P=0.836). The effects of ACE inhibitor and ARB use on the outcomes were generally consistent across all clinically relevant subgroups examined, including age, sex, etiology, EF, hypertension, diabetes mellitus, and beta-blocker use. Discharge use of ARBs provided comparable effects with ACE inhibitors on outcomes in patients hospitalized for HF. These findings provide further support for guideline recommendations that ARBs can be used in patients with HF and LVSD as an alternative of ACE inhibitors.

Authors+Show Affiliations

Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19960016

Citation

Tsuchihashi-Makaya, Miyuki, et al. "Discharge Use of Angiotensin Receptor Blockers Provides Comparable Effects With Angiotensin-converting Enzyme Inhibitors On Outcomes in Patients Hospitalized for Heart Failure." Hypertension Research : Official Journal of the Japanese Society of Hypertension, vol. 33, no. 3, 2010, pp. 197-202.
Tsuchihashi-Makaya M, Furumoto T, Kinugawa S, et al. Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure. Hypertens Res. 2010;33(3):197-202.
Tsuchihashi-Makaya, M., Furumoto, T., Kinugawa, S., Hamaguchi, S., Goto, K., Goto, D., Yamada, S., Yokoshiki, H., Takeshita, A., & Tsutsui, H. (2010). Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure. Hypertension Research : Official Journal of the Japanese Society of Hypertension, 33(3), 197-202. https://doi.org/10.1038/hr.2009.199
Tsuchihashi-Makaya M, et al. Discharge Use of Angiotensin Receptor Blockers Provides Comparable Effects With Angiotensin-converting Enzyme Inhibitors On Outcomes in Patients Hospitalized for Heart Failure. Hypertens Res. 2010;33(3):197-202. PubMed PMID: 19960016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Discharge use of angiotensin receptor blockers provides comparable effects with angiotensin-converting enzyme inhibitors on outcomes in patients hospitalized for heart failure. AU - Tsuchihashi-Makaya,Miyuki, AU - Furumoto,Tomoo, AU - Kinugawa,Shintaro, AU - Hamaguchi,Sanae, AU - Goto,Kazutomo, AU - Goto,Daisuke, AU - Yamada,Satoshi, AU - Yokoshiki,Hisashi, AU - Takeshita,Akira, AU - Tsutsui,Hiroyuki, AU - ,, Y1 - 2009/12/04/ PY - 2009/12/5/entrez PY - 2009/12/5/pubmed PY - 2010/6/11/medline SP - 197 EP - 202 JF - Hypertension research : official journal of the Japanese Society of Hypertension JO - Hypertens. Res. VL - 33 IS - 3 N2 - Large-scale, placebo-controlled, randomized clinical trials have shown that angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) reduce mortality and hospitalization in patients with heart failure (HF) caused by left ventricular systolic dysfunction (LVSD). However, it is unknown whether ACE inhibitors and ARBs have similar effects on the long-term outcomes in HF patients encountered in routine clinical practice. The Japanese Cardiac Registry of Heart Failure in Cardiology enrolled HF patients hospitalized with worsening symptoms and they were followed during an average of 2.2 years. The outcome data were compared in patients with LVSD by echocardiography (ejection fraction, EF <40%) according to the predischarge use of ACE inhibitors (n=356) or ARBs (n=372). The clinical characteristics were similar between patients with ACE inhibitor and ARB use, except for higher prevalence of hypertensive etiology and diabetes mellitus. There was no significant difference between ACE inhibitor and ARB use in all-cause death (adjusted hazard ratio 0.958, 95% confidence interval 0.601-1.527, P=0.858) and rehospitalization (adjusted hazard ratio 0.964, 95% confidence interval 0.683-1.362, P=0.836). The effects of ACE inhibitor and ARB use on the outcomes were generally consistent across all clinically relevant subgroups examined, including age, sex, etiology, EF, hypertension, diabetes mellitus, and beta-blocker use. Discharge use of ARBs provided comparable effects with ACE inhibitors on outcomes in patients hospitalized for HF. These findings provide further support for guideline recommendations that ARBs can be used in patients with HF and LVSD as an alternative of ACE inhibitors. SN - 1348-4214 UR - https://www.unboundmedicine.com/medline/citation/19960016/Discharge_use_of_angiotensin_receptor_blockers_provides_comparable_effects_with_angiotensin_converting_enzyme_inhibitors_on_outcomes_in_patients_hospitalized_for_heart_failure_ L2 - http://dx.doi.org/10.1038/hr.2009.199 DB - PRIME DP - Unbound Medicine ER -