Beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are associated with better long-term outcomes among aortic dissection (AD) patients than other antihypertensive medications, according to a new analysis in JAMA Network Open.
“Several animal studies have shown that treatment with an ACE inhibitor or ARB slows aortic aneurysm progression and prevents rupture,” wrote lead author Shao-Wei Chen, MD, PhD, a thoracic and cardiovascular surgery specialist at Chang Gung University in Taiwan, and colleagues. “A randomized clinical trial assessing the use of irbesartan for Marfan syndrome showed that ARBs decreased aortic expansion. However, no randomized clinical trial has compared the effects of long-term treatment with beta-blockers, ACE inhibitors or ARBs with those of other antihypertensive medications after AD.”
Researchers studied nearly 7,000 adult patients with AD who were treated from 2001 to 2013. Each patient was prescribed either a beta-blocker, an ACE inhibitor, an ARB or another hypertension medication within 90 days of discharge. Data were gathered from Taiwan’s National Health Insurance Research Database.
Overall, the authors found that beta-blockers, ACE inhibitors and ARBs were all associated with lower in-hospital mortality and a lower risk of all-cause hospital readmission than the other medications. The risk of all-cause mortality, the team added, was lower for ARB patients than ACE inhibitor patients.
The study did have certain limitations, including its retrospective design and the fact that the National Health Insurance Research Database did not include specific data related to blood pressure. Overall, though, Chen et al. said that their study “provides results beneficial for clinicians selecting drugs for the long-term treatment of AD.”
Click here to read the full analysis from JAMA Network Open.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.