Effect of Renin-Angiotensin System Inhibition on Cardiovascular Events in Older Hypertensive Patients with Metabolic Syndrome
| Autor: | Kai I. Cheang, Spencer E. Harpe, Hala H. Zreikat, Paulina A. Essah, Patricia W. Slattum, Darcy P. Mays |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Angiotensin-Converting Enzyme Inhibitors Article Renin-Angiotensin System chemistry.chemical_compound Angiotensin Receptor Antagonists Endocrinology High-density lipoprotein Insulin resistance Internal medicine Renin–angiotensin system medicine Humans cardiovascular diseases Myocardial infarction Prospective Studies National Cholesterol Education Program Antihypertensive Agents Aged Metabolic Syndrome biology business.industry Angiotensin-converting enzyme medicine.disease chemistry Cardiovascular Diseases Hypertension biology.protein Cardiology Female Metabolic syndrome business |
| Popis: | Metabolic syndrome (MetS) is associated with cardiovascular disease (CVD). Insulin resistance has been hypothesized as the underlying feature of MetS. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are widely used antihypertensives that may improve insulin sensitivity. The aim of the study is to evaluate the effect of ACEI/ARB on incident CVD events in older hypertensive patients with MetS.We used the Cardiovascular Health Study, a prospective cohort study of individuals65years of age to evaluate ACEI/ARB use and time to CVD events (including coronary and cerebrovascular events). The study included 777 subjects who had hypertension and ATP III-defined MetS, but free of CVD and diabetes at baseline. Cox regression models were used to evaluate the effect of ACEI/ARB as compared to other antihypertensives on the time to the first CVD events.ACEI/ARB use was associated with a decreased risk of CVD events (adjusted HR=0.658, 95 % C.I. [0.436-0.993]) compared to other antihypertensives. When CVD endpoints were evaluated separately, use of ACEI/ARB was associated with lower rates of angioplasty and coronary events (HR of 0.129 and 0.530 respectively, with 95 % CI [0.017-0.952] and [0.321-0.875]).ACEI/ARB use was associated with a lower risk of CVD events in older hypertensive patients with MetS, primarily due to a reduction in coronary events. The potential protective effect of ACEI/ARB on CVD events in older individuals with MetS will need further confirmation from prospective studies. |
| Databáze: | OpenAIRE |
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