Angiotensin inhibition in renovascular disease: a population-based cohort study.

摘要: Background Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers effectively reduce blood pressure in patients with renovascular disease (RVD); yet, randomized cardiovascular prevention trials of these drugs typically exclude individuals this condition. Patients Methods We studied the association renin-angiotensin system inhibition prognosis a population-based cohort comprising 3,570 RVD Ontario, Canada; slightly more than half (n = 1,857, 53%) were prescribed inhibitors. The primary outcome was composite death, myocardial infarction, or stroke. Secondary outcomes included individual renal events. Results receiving had significantly lower risk for during follow-up (10.0 vs 13.0 events per 100 patient-years at risk, multivariable adjusted hazard ratio [HR] 0.70, 95% CI 0.59-0.82). In addition, hospitalization congestive heart failure (HR 0.69, 0.53-0.90), chronic dialysis initiation 0.62, 0.42-0.92), mortality 0.56, 0.47-0.68) treated patients. Conversely, likely to be hospitalized acute 1.87, 1.05-3.33; 1.2 0.6 risk). Conclusions These data emphasize high vascular suggest that may improve setting expense toxicity. If latter are selected management RVD, function parameters should assiduously followed.