{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T18:32:39Z","timestamp":1771266759893,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,10,20]],"date-time":"2014-10-20T00:00:00Z","timestamp":1413763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>In response to safety concerns from two large randomized controlled trials, we investigated whether the use of telmisartan, an angiotensin receptor blocker (<jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>s as a class and angiotensin\u2010converting enzyme inhibitors (<jats:styled-content style=\"fixed-case\">ACEI<\/jats:styled-content>s) increase the risk of sepsis, sepsis\u2010associated mortality and renal failure in hypertensive patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a nested case\u2013control study from a retrospective cohort of adults with hypertension from the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> General Practice Research Database diagnosed between 1 <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 2000 and 30 <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2009. All subjects hospitalized with sepsis during follow\u2010up were matched for age, sex, practice and duration of follow\u2010up with 10 control subjects. Exposure was defined as current use of antihypertensive drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From the cohort of 550\u2009436 hypertensive patients, 1965 were hospitalized with sepsis during follow\u2010up (rate 6.9 per 10\u2009000 per year), of whom 824 died and 346 developed acute renal failure within 30 days. Compared with use of \u03b2\u2010blockers, calcium\u2010channel blockers or diuretics, use of <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>s, including telmisartan, was not associated with an elevated risk of sepsis (relative risk 1.09; 95% confidence interval 0.83\u20131.43); but use <jats:styled-content style=\"fixed-case\">ACEI<\/jats:styled-content>s was (relative risk 1.65; 95% confidence interval 1.42\u20131.93). Users of <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>s, \u03b2\u2010blockers, calcium\u2010channel blockers or diuretics, but not users of <jats:styled-content style=\"fixed-case\">ACEI<\/jats:styled-content>s, had lower rates of hospitalization for sepsis compared with untreated hypertensive patients. Findings were similar for sepsis\u2010related 30 day mortality and renal failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hypertensive patients treated with <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>s, including telmisartan, do not appear to be at increased risk of sepsis or sepsis\u2010related 30 day mortality or renal failure. On the contrary, users of <jats:styled-content style=\"fixed-case\">ACEI<\/jats:styled-content>s may have an increased risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.12419","type":"journal-article","created":{"date-parts":[[2014,5,7]],"date-time":"2014-05-07T02:03:26Z","timestamp":1399428206000},"page":"1151-1158","source":"Crossref","is-referenced-by-count":38,"title":["Antihypertensive agents acting on the renin\u2013angiotensin system and the risk of sepsis"],"prefix":"10.1111","volume":"78","author":[{"given":"Sandra","family":"Dial","sequence":"first","affiliation":[{"name":"Department of Critical Care Jewish General Hospital  Montreal Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon J.","family":"Nessim","sequence":"additional","affiliation":[{"name":"Department of Critical Care Jewish General Hospital  Montreal Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas","family":"Kezouh","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology Lady Davis Institute Jewish General Hospital  Montreal Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacques","family":"Benisty","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology Lady Davis Institute Jewish General Hospital  Montreal Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samy","family":"Suissa","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology Lady Davis Institute Jewish General Hospital  Montreal Canada"},{"name":"Department of Epidemiology and Biostatistics McGill University  Montreal Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61242-8"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70198-4"},{"key":"e_1_2_8_4_1","unstructured":"FDA clinical review: NDA 20\u2010850 efficacy supplement SE1\u2010025 micardis (telmisartan) tablets. 29\u20107\u20102009. 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