{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T20:53:23Z","timestamp":1793566403349,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"17","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2017,2,3]]},"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely prescribed in patients with high cardiovascular (CV) risk. However, whether both classes have equivalent effectiveness to prevent CV events remains unclear. The aim of this study was to compare the incidence of major CV events between ACEI and ARB users.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The Reduction of Atherothrombosis for Continued Health registry is an observational study who enrolled 69\u2009055 individuals with high CV risk. Among them, 40\u2009625 patients (ACEIs 67.9% and ARBs 32.1%) were included. Main outcome was rates of CV mortality, non-fatal myocardial infarction, non-fatal stroke or hospitalisation for CV disease at 4 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In a propensity score-adjusted cohort, the incidence of the primary outcome was lower in patients on ARBs compared with ACEIs (29.2% vs 33.4%; adjusted HR 0.90; 95%\u2009CI 0.86 to 0.95; p&lt;0.001). Similar results were observed for CV (6.9% vs 8.2%; HR 0.83; 95%\u2009CI 0.75 to 0.93; p=0.001) and all-cause mortality (11.6% vs 12.6%; HR 0.89; 95%\u2009CI 0.82 to 0.97; p=0.005). Analyses using propensity score matching yielded similar results. History of diabetes or estimated glomerular filtration rate did not affect the results. ARB use was associated with lower rates of all-cause mortality in secondary prevention but not in primary prevention patients (p-value for interaction=0.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>ARB use appears to be associated with 10% lower rates of CV events compared with ACEIs, especially in patients with established CV disease. Our results suggest that ARBs may provide superior protection against CV events than ACEIs in high-risk patients in real-world practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2016-310705","type":"journal-article","created":{"date-parts":[[2017,3,11]],"date-time":"2017-03-11T20:10:16Z","timestamp":1489263016000},"page":"1339-1346","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":41,"title":["Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in high vascular risk"],"prefix":"10.1136","volume":"103","author":[{"given":"Louis","family":"Potier","sequence":"first","affiliation":[{"name":"D\u00e9partement d'Endocrinologie, Diab\u00e9tologie et Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France"},{"name":"Universit\u00e9 Paris Diderot-Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"Centre de Recherche des Cordeliers, INSERM, U-1138, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronan","family":"Roussel","sequence":"additional","affiliation":[{"name":"D\u00e9partement d'Endocrinologie, Diab\u00e9tologie et Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France"},{"name":"Universit\u00e9 Paris Diderot-Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"Centre de Recherche des Cordeliers, INSERM, U-1138, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yedid","family":"Elbez","sequence":"additional","affiliation":[{"name":"FACT DHU FIRE, LVTS INSERM U-1148, H\u00f4pital Bichat, HUPNVS, AP-HP, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Marre","sequence":"additional","affiliation":[{"name":"D\u00e9partement d'Endocrinologie, Diab\u00e9tologie et Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France"},{"name":"Universit\u00e9 Paris Diderot-Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"Centre de Recherche des Cordeliers, INSERM, U-1138, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Zeymer","sequence":"additional","affiliation":[{"name":"Klinikum Ludwigshafen und Institut f\u00fcr Herzinfarktforschung, Ludwigshafen, Rhineland-Palatinate, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M","family":"Reid","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, School of Public Health, Curtin University, Centre of Cardiovascular Research and Education in Therapeutics, Melbourne, Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Ohman","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University Medical Center and the Duke Clinical Research Institute, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim A","family":"Eagle","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Michigan Health System, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak L","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Diderot-Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"FACT DHU FIRE, LVTS INSERM U-1148, H\u00f4pital Bichat, HUPNVS, AP-HP, Paris, France"},{"name":"NHLI Imperial College, Royal Brompton Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,3,11]]},"reference":[{"key":"2025092101595916000_103.17.1339.1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000096609.73772.C5"},{"key":"2025092101595916000_103.17.1339.2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.mayocp.2015.10.019","article-title":"Angiotensin-Converting enzyme inhibitors or angiotensin receptor blockers in patients without heart failure? 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