{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T02:57:02Z","timestamp":1779245822526,"version":"3.51.4"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p xml:lang=\"en\">Angiotensin II receptor blockers (ARBs) and angiotensin\u2010converting enzyme inhibitors (ACEIs) block distinct components of the renin\u2010angiotensin system. Whether this translates into differential effects on cardiovascular disease events remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>METHODS AND RESULTS<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We used the ACCORD\u2010BP (Action to Control Cardiovascular Risk in Diabetes\u2013Blood Pressure) trial and the SPRINT (Systolic Blood Pressure Intervention Trial) to emulate target trials of new users of ARBs versus ACEIs on cardiovascular disease events (primary outcome) and death (secondary outcome). We estimated marginal cause\u2010specific hazard ratios (HRs) and treatment\u2010specific cumulative incidence functions with inverse probability of treatment weights. We identified 3298 new users of ARBs or ACEIs (ACCORD\u2010BP: 374 ARB versus 884 ACEI; SPRINT: 727 ARB versus 1313 ACEI). For participants initiating ARBs versus ACEIs, the inverse probability of treatment weight rate of the primary outcome was 3.2 versus 3.5 per 100 person\u2010years in ACCORD\u2010BP (HR, 0.91 [95% CI, 0.63\u20131.31]) and 1.8 versus 2.2 per 100 person\u2010years in SPRINT (HR, 0.81 [95% CI, 0.56\u20131.18]). There were no appreciable differences in pooled analyses, except that ARBs versus ACEIs were associated with a lower death rate (HR, 0.56 [95% CI, 0.37\u20130.85]). ARBs were associated with a lower rate of the primary outcome among subgroups of male versus female participants, non\u2010Hispanic Black versus non\u2010Hispanic White participants, and those randomly assigned to standard versus intensive blood pressure (\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              : &lt;0.01, 0.05, and &lt;0.01, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>CONCLUSIONS<\/jats:title>\n            <jats:p xml:lang=\"en\">In this secondary analysis of ACCORD\u2010BP and SPRINT, new users of ARB\u2010 versus ACEI\u2010based antihypertensive medication regimens experienced similar cardiovascular disease events rates, with important subgroup differences and lower rates of death overall.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>REGISTRATION<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifiers: NCT01206062, NCT00000620.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030311","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T09:29:04Z","timestamp":1693387744000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["New Users of Angiotensin II Receptor Blocker\u2013Versus Angiotensin\u2010Converting Enzyme Inhibitor\u2013Based Antihypertensive Medication Regimens and Cardiovascular Disease Events: A Secondary Analysis of ACCORD\u2010BP and SPRINT"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6783-7951","authenticated-orcid":false,"given":"Jordan B.","family":"King","sequence":"first","affiliation":[{"name":"Intermountain Healthcare Department of Population Health Sciences University of Utah Spencer Fox Eccles School of Medicine UT Salt Lake City USA"},{"name":"Institute for Health Research Kaiser Permanente Colorado CO Aurora USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6883-6822","authenticated-orcid":false,"given":"Ransmond O.","family":"Berchie","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare Department of Population Health Sciences University of Utah Spencer Fox Eccles School of Medicine UT Salt Lake City USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7382-4607","authenticated-orcid":false,"given":"Catherine G.","family":"Derington","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare Department of Population Health Sciences University of Utah Spencer Fox Eccles School of Medicine UT Salt Lake City USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-2304","authenticated-orcid":false,"given":"Zachary A.","family":"Marcum","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, School of Pharmacy University of Washington WA Seattle USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel O.","family":"Scharfstein","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare Department of Population Health Sciences University of Utah Spencer Fox Eccles School of Medicine UT Salt Lake City USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom H.","family":"Greene","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare Department of Population Health Sciences University of Utah Spencer Fox Eccles School of Medicine UT Salt Lake City USA"},{"name":"Department of Internal Medicine University of Utah Spencer Fox Eccles School 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