Chichester, UK: John Wiley & Sons Ltd; 2008:347-360. The drug that was most commonly prescribed within its class was used as the reference drug (enalapril for the ACE inhibitors and losartan for the ARBs). 2005;365(9463):939-946. Further evidence emerges supporting ACE inhibitor use in dementia. Funding Source: No funding was received for this study. A switch was defined as an RAS-inhibiting agent permanently substituting for the initial drug therapy.39 Specific analysis was performed for switches from an ACE inhibitor to an ARB, which can be related to adverse events, in particular angioedema and dry cough.8,24 Differences in switching patterns were analyzed compared with the reference drug, adjusting for age, sex, year of initiating therapy, and comorbidities. Available at E-mail: s.vegter@rug.nl. Switching from lisinopril to losartan may help reduce the likelihood of developing a dry cough. Automated pharmacy record linkage in the Netherlands. Sharma PP. In people with stage 3 chronic kidney disease (GFR > 30 ml/min) the combination of an ACE inhibitor with an ARB reduced urine protein levels but did not reduce cardiovascular outcomes and did increase adverse renal outcomes including the need for acute dialysis compared to the ACE inhibitor alone 4. Medication compliance and persistence: terminology and definitions. Gogovor A, Dragomir A, Savoie M, Perreault S. Comparison of persistence rates with angiotensin-converting enzyme inhibitors used in secondary and primary prevention of cardiovascular disease. “Based on our results, if there is a risk difference, it’s marginal and would be very challenging to further refine outside such a large-scale international study,” Suchard said. Dusing R. Adverse events, compliance, and changes in therapy. 2007;10(5):431-441. 2002;359(9311):995-1003. The most frequently prescribed RAS inhibitors were enalapril and losartan. 14. Br J Clin Pharmacol.2008;66(2):313-315. No competing interests, Cardiovascular and Transplant Surgery Centre, Copyright © 2021 BMJ Publishing Group Ltd 京ICP备15042040号-3, https://www.bmj.com/content/368/bmj.m406/rr-19, https://doi.org/10.1038/s41569-020-0360-5, Women’s, children’s & adolescents’ health, Switching from ACE inhibitors to ARB in preventing severe course of COVID-19. Comparative clinical- and cost-effectiveness of candesartan and losartan in the management of hypertension and heart failure: a systematic review, meta- and cost-utility analysis. 32. 2002;16(8):569-575. Garg R, Yusuf S. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure: Collaborative Group on ACE Inhibitor Trials [published correction appears in JAMA. By design, none of these patients had switched or permanently discontinued RAS therapy. COVID-19 and the cardiovascular system. Bergman U. Based on empiricalstudies to predict hospitalizations for hypertension and congestive HF,35 a threshold of 80% was used to dichotomize between compliant and noncompliant patients. Pharmacoepidemiol Drug Saf. Higher patient age and comedication for dyslipidemia increased the chance of being compliant (9.4% and 25.6% over 10 years, respectively, P <.001), while comedication for COPD and later year of initiating therapy decreased the chance of being compliant (-24.3% per year [P = .005] and -1.5% per year [P = .035], respectively). c)Among the sample, patients who discontinued ACE-I or ARB therapy were associated with a higher risk of mortality (hazard ratio [HR], 1.39; and MACE (HR, 1.37; ), but no statistically significant difference in the risk of ESKD was found. N Engl J Med. OR. Ambrosioni E, Leonetti G, Pessina AC, Rappelli A, Trimarco B, Zanchetti A. 2005;19(10):793-799. 2009;16(2):329-335. Diabetes mellitus (DM) therapy was identified by prescription of glucose-lowering drugs (ATC A10).27 Dyslipidemia therapy was identified by prescription of lipid-lowering drugs (ATC C10).27 Ischemic heart disease (IHD) therapy was identified by prescription of either nitrates (ATC C01DA) or platelet aggregation inhibitors (ATC B01AC).28 Heart failure (HF) therapy was identified by prescription of either digoxin (ATC C01AA05) or loop diuretics (ATC C03C).29 Chronic obstructive pulmonary disease (COPD) therapy was identified by incident use of adrenergic inhalants (ATC R03A) or anticholinergic inhalants (ATC R03BB) in patients 55 years or older.30 Incident use of COPD therapy was defined as the first use of an inhaler while being known in the database for at least 1 year.
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