Key result
Angiotensin receptor blockers were associated with a milder inflammatory bowel disease course and lower rates of immunomodulator use (P=0.038) after adjustment for confounding factors.
Why the study?
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been linked to improved inflammatory bowel disease outcomes, prompting investigation into the potential effects of antihypertensive medications on disease course.
Do renin-angiotensin system inhibitors improve the disease course in patients with inflammatory bowel disease?
Case-Control (n=300)
Do renin-angiotensin system inhibitors improve the disease course in patients with inflammatory bowel disease?
Odds Ratio: 1.191 (95% CI 1.005–1.411)
Angiotensin receptor blockers may have a protective effect on the clinical course of inflammatory bowel disease, potentially reducing the need for immunomodulators and steroids.
BACKGROUND: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been associated with improved outcomes in inflammatory bowel disease. We aimed to investigate any possible effect of antihypertensive medications on inflammatory bowel disease course. METHODS: One hundred and fifty inflammatory bowel disease patients with hypertension were compared using a 1:1 ratio with age- and gender-matched control patients with inflammatory bowel disease. The class of antihypertensive medication, traditional risk factors for atherosclerosis, inflammatory bowel disease characteristics, and history (surgery, hospitalizations, and treatment) were retrospectively analyzed. RESULTS: Of 150 (44.7% Crohn's disease) patients with hypertension, 46.7% were on angiotensin receptor blockers, 30.6% on angiotensin-converting enzyme inhibitors, 40% on β-blockers, and 40.7% on calcium channel blockers. Univariate analysis revealed significantly higher rates of traditional risk factors for atherosclerosis among antihypertensive users. When analyzing by class of antihypertensive medication, angiotensin receptor blockers were significantly associated with milder course as indicated by less frequent immunomodulator (P = 0.039) and steroid use (P = 0.041). Rates of lifetime steroids were statistically significantly lower among angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (odds ratio = 1.191, 95% confidence interval, 1.005-1.411). After adjustment with confounding factors, only angiotensin receptor blockers were associated with milder inflammatory bowel disease course (P = 0.037) and lower rates of immunomodulator use (P = 0.038). CONCLUSIONS: Our study suggests a possible protective effect of angiotensin receptor blockers on overall inflammatory bowel disease course by targeting the renin-angiotensin system. Their effect on inflammatory bowel disease needs to be studied in larger cohorts.
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Μantaka et al. (2020) conducted a case-control in Inflammatory bowel disease (n=300). Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers vs. Age- and gender-matched control patients with inflammatory bowel disease was evaluated on Rates of lifetime steroids (OR 1.191, 95% CI 1.005-1.411). Angiotensin receptor blockers were associated with a milder inflammatory bowel disease course and lower rates of immunomodulator use (P=0.038) after adjustment for confounding factors.
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