A031: ACE inhibitors and outcome in treated hypertensive patients

The aim, of this study was to assess the influence of ACE inhibitors (ACEIs) on mortality in treated hypertensive patients. The Glasgow Blood Pressure Clinic holds on its computer database information on 11,000 hypertensive patients. Each is record-linked with the Registrar General Scotland for information on deaths. ACEIs were first prescribed at the Clinic in 1980. Between 1 January 1980 and 31 December 1995, 5207 patients received prescriptions for ACEIs or other antihypertensive drugs (ACEI 1559; never ACEI 3648). This report describes a retrospective cohort study of this population. Results using Cox's proportional hazards model adjusted for age, sex, epoch (4 years) of first prescription, and all other relevant patient characteristics are shown in the Table.TABLERelative Hazard Ratios (95% CI) ACEI vs Never ACEI Number of deaths Adjusted for age sex and epoch Adjusted for all patient characteristics All cause 857 0.76 (0.63, 0.91) 0.74 (0.61, 0.89) Cardiovascular 564 0.81 (0.65, 1.01) 0.76 (0.62, 0.97) CHD 349 0.76 (0.57, 1.02) 0.73 (0.55, 0.98) Stroke 132 0.81 (0.51, 1.29) 0.76 (0.48, 1.21) Other vascular 83 1.02 (0.58, 1.81) 1.04 (0.58, 1.86) Cancer 172 0.65 (0.43, 0.98) 0.65 (0.43, 0.94) Other causes 121 0.72 (0.45, 1.14) 0.76 (0.46, 1.17) Imbalance in risk factors does not account for the apparent survival advantage in patients receiving ACEIs. This study provides preliminary evidence that mortality from all causes and cardiovascular diseases may be reduced in hypertensive patients prescribed ACEIs. The duration of follow-up in this population may have allowed the demonstration of benefits.