AIMS: In response to safety concerns from two large randomized controlled trials, we investigated whether the use of telmisartan, an angiotensin receptor blocker (ARB), ARBs as a class and angiotensin-converting enzyme inhibitors (ACEIs) increase the risk of sepsis, sepsis-associated mortality and renal failure in hypertensive patients. METHODS: We performed a nested case-control study from a retrospective cohort of adults with hypertension from the UK General Practice Research Database diagnosed between 1 January 2000 and 30 June 2009. All subjects hospitalized with sepsis during follow-up were matched for age, sex, practice and duration of follow-up with 10 control subjects. Exposure was defined as current use of antihypertensive drugs. RESULTS: From the cohort of 550 436 hypertensive patients, 1965 were hospitalized with sepsis during follow-up (rate 6.9 per 10 000 per year), of whom 824 died and 346 developed acute renal failure within 30 days. Compared with use of β-blockers, calcium-channel blockers or diuretics, use of ARBs, including telmisartan, was not associated with an elevated risk of sepsis (relative risk 1.09; 95% confidence interval 0.83-1.43); but use ACEIs was (relative risk 1.65; 95% confidence interval 1.42-1.93). Users of ARBs, β-blockers, calcium-channel blockers or diuretics, but not users of ACEIs, had lower rates of hospitalization for sepsis compared with untreated hypertensive patients. Findings were similar for sepsis-related 30 day mortality and renal failure. CONCLUSIONS: Hypertensive patients treated with ARBs, including telmisartan, do not appear to be at increased risk of sepsis or sepsis-related 30 day mortality or renal failure. On the contrary, users of ACEIs may have an increased risk.
AIMS: In response to safety concerns from two large randomized controlled trials, we investigated whether the use of telmisartan, an angiotensin receptor blocker (ARB), ARBs as a class and angiotensin-converting enzyme inhibitors (ACEIs) increase the risk of sepsis, sepsis-associated mortality and renal failure in hypertensivepatients. METHODS: We performed a nested case-control study from a retrospective cohort of adults with hypertension from the UK General Practice Research Database diagnosed between 1 January 2000 and 30 June 2009. All subjects hospitalized with sepsis during follow-up were matched for age, sex, practice and duration of follow-up with 10 control subjects. Exposure was defined as current use of antihypertensive drugs. RESULTS: From the cohort of 550 436 hypertensivepatients, 1965 were hospitalized with sepsis during follow-up (rate 6.9 per 10 000 per year), of whom 824 died and 346 developed acute renal failure within 30 days. Compared with use of β-blockers, calcium-channel blockers or diuretics, use of ARBs, including telmisartan, was not associated with an elevated risk of sepsis (relative risk 1.09; 95% confidence interval 0.83-1.43); but use ACEIs was (relative risk 1.65; 95% confidence interval 1.42-1.93). Users of ARBs, β-blockers, calcium-channel blockers or diuretics, but not users of ACEIs, had lower rates of hospitalization for sepsis compared with untreated hypertensivepatients. Findings were similar for sepsis-related 30 day mortality and renal failure. CONCLUSIONS:Hypertensivepatients treated with ARBs, including telmisartan, do not appear to be at increased risk of sepsis or sepsis-related 30 day mortality or renal failure. On the contrary, users of ACEIs may have an increased risk.
Authors: Susan S Jick; James A Kaye; Catherine Vasilakis-Scaramozza; Luis A Garcia Rodríguez; Ana Ruigómez; Christoph R Meier; Raymond G Schlienger; Corri Black; Hershel Jick Journal: Pharmacotherapy Date: 2003-05 Impact factor: 4.705
Authors: Giuseppe Mancia; Robert Fagard; Krzysztof Narkiewicz; Josep Redón; Alberto Zanchetti; Michael Böhm; Thierry Christiaens; Renata Cifkova; Guy De Backer; Anna Dominiczak; Maurizio Galderisi; Diederick E Grobbee; Tiny Jaarsma; Paulus Kirchhof; Sverre E Kjeldsen; Stéphane Laurent; Athanasios J Manolis; Peter M Nilsson; Luis Miguel Ruilope; Roland E Schmieder; Per Anton Sirnes; Peter Sleight; Margus Viigimaa; Bernard Waeber; Faiez Zannad Journal: J Hypertens Date: 2013-07 Impact factor: 4.844
Authors: Zakir Khan; Xiao Z Shen; Ellen A Bernstein; Jorge F Giani; Masahiro Eriguchi; Tuantuan V Zhao; Romer A Gonzalez-Villalobos; Sebastien Fuchs; George Y Liu; Kenneth E Bernstein Journal: Blood Date: 2017-05-17 Impact factor: 22.113
Authors: Larry A Weinrauch; Jiankang Liu; Brian Claggett; Peter V Finn; Matthew R Weir; John A D'Elia Journal: Int J Nephrol Renovasc Dis Date: 2017-12-22
Authors: Patrick Bidulka; Masao Iwagami; Kathryn E Mansfield; Fotini Kalogirou; Angel Y S Wong; Ian J Douglas; Liam Smeeth; Charlotte Summers; Laurie A Tomlinson Journal: Wellcome Open Res Date: 2020-04-27