Combination ACE inhibitor therapy increases risk of kidney failure and death

New research from CMAJ

2011-03-22

(Press-News.org) Elderly patients prescribed combination angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) had a higher risk of kidney failure and death, according to a study published in CMAJ (Canadian Medical Association Journal) .

This study, by researchers from the University of Alberta and the University of Calgary, sought to determine the safety of combination therapy of ACE inhibitors and ARB in the clinical setting as some randomized trials indicate an increased risk of kidney failure. Randomized trials may over or underestimate the risk of adverse events possibly because of patient selection bias, higher drug doses and increased monitoring.

The researchers looked at 32 312 seniors in Alberta, Canada, aged 65 and older who were prescribed an ACE inhibitor and/or an ARB. They compared patients receiving both drugs together with patients who received only one of the drugs. They found a higher risk of adverse events such as high creatinine levels, end-stage renal disease and death in people taking combination therapy.

"We found that less than one-seventh of the elderly residents of Alberta who were given combination therapy in clinical practice had either of the conditions for which this therapy has been proven beneficial in randomized trials (i.e., proteinuria or symptomatic left ventricular systolic dysfunction despite treatment with and ACE inhibitor or an angiotensin-receptor blocker alone," writes Dr. Finlay McAlister, University of Alberta, with coauthors.

As well, they observed that within three months, most patients stopped the combination therapy. The authors speculate this may have been due to low blood pressure.

"Our most striking findings were that combination therapy was commonly prescribed for patients who did not have the trial-proven indications and that it was frequently stopped after only a few months, even when hyperkalemia or renal dysfunction did not occur," conclude the researchers.

### END

ELSE PRESS RELEASES FROM THIS DATE:

LateRooms.com - See Hayseed Dixie During a Cotswold Stay

2011-03-22

Hayseed Dixie will bring their unique blend of bluegrass and rock music to the Cotswolds on Tuesday April 26th. The American band, who emerged in 2001 with the release of their debut album A Hillbilly Tribute to AC/DC, have scheduled a performance at the Gloucester Guildhall. With several more LPs now under their belt, in addition to well-received performances at festivals such as Glastonbury and Download, the group have won plenty of admirers for their eccentric and tongue-in-cheek approach to making music. According to the official Hayseed Dixie website, the ...

Primordial soup gets spicier

2011-03-22

Stanley Miller gained fame with his 1953 experiment showing the synthesis of organic compounds thought to be important in setting the origin of life in motion. Five years later, he produced samples from a similar experiment, shelved them and, as far as friends and colleagues know, never returned to them in his lifetime. More 50 years later, Jeffrey Bada, Miller's former student and a current Scripps Institution of Oceanography, UC San Diego professor of marine chemistry, discovered the samples in Miller's laboratory material and made a discovery that represents a potential ...

LateRooms.com - Soak Up Some Culture at Sydney's Musica Viva Festival

2011-03-22

Sydney's Musica Viva Festival (MVF) takes place next month, combining emerging talent from the Australian Youth Orchestra with some of the world's finest artists. They are set to come together at the New South Wales capital's Conservatorium of Music (CoM) for a series of collaborations that will be "bursting with energy and freshness", according to the organisers. The event consists of concerts, masterclasses and talks from the performers and other key guests. Highlights include a rendition of Graeme Koehne's Clarinet Quintet featuring Philip Arkinstall and the ...

Study suggests gastric banding associated with relatively poor long-term outcomes

2011-03-22

In a study of 82 patients who were evaluated 12 or more years after undergoing laparoscopic adjustable gastric banding for morbid obesity, a majority of patients reported that they were satisfied with the procedure, although approximately 40 percent experienced major complications and nearly half required removal of their bands, according to a report posted online that will appear in the July print issue of Archives of Surgery, one of the JAMA/Archives journals. "There is substantial evidence that surgery is the only valid treatment for morbid obesity," the authors write ...

Melanoma diagnosis in women associated with higher socioeconomic status

2011-03-22

The incidence of melanoma appears higher in non-Hispanic white adolescent girls and young women living in higher socioeconomic neighborhoods than those living in lower socioeconomic areas, according to a report posted online today that will appear in the July print issue of Archives of Dermatology, one of the JAMA/Archives journals. "Melanoma is the most lethal form of skin cancer and represents a substantial cause of productive years of life lost to cancer, especially when occurring in young persons," the authors write as background information in the study. "Among non-Hispanic ...

Newborn hearing screenings do not appear to identify all children at risk for hearing loss

2011-03-22

Although universal newborn hearing screening programs appear to identify children with hearing loss at a younger age, nearly one-third of pediatric cochlear implant recipients pass newborn screening only to be diagnosed later in infancy or early childhood, according to a report in the March issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals. "When universal newborn hearing screening programs (UNHS) were initially conceived, it was presumed that most hearing-impaired children, especially those without risk factors for progressive ...

LateRooms.com - La Mirada Film Festival Coming to Melbourne

2011-03-22

Some of the best contemporary and classic Spanish language movies will be showcased at La Mirada Film Festival (LMFF) in Melbourne next month. The organisers have called on a host of famous names to act as guest curators, including Brokeback Mountain director Ang Lee, Pan's Labyrinth filmmaker Guillermo del Toro and Desperado star Antonio Banderas. LMFF 2011 runs from April 14th to 26th, kicking off with the Opening Night Gala at La Mirada Lounge, next door to ACMI Cinemas. Director Gustavo Taretto has been lined up to appear at the event. Guests will have the ...

Changes in taste function related to obesity and chronic ear inflammation

2011-03-22

Children with chronic inflammation of the middle ear can experience changes in their sense of taste, and these changes may be related to childhood obesity, according to a report in the March issue of Archives of Otolaryngology – Head & Neck Surgery, one of the JAMA/Archives journals. Chronic otitis media with effusion is a persistent inflammation of the middle ear, in which effusion fluid is retained in the middle ear cavity. "Otitis media with effusion (OME) is a disease with a high incidence in childhood and is a common cause of hearing disturbances in children," the ...

Periocular treatment improves eye comfort and quality of life for patients with facial paralysis

2011-03-22

Patients with facial paralysis who underwent surgical treatment for a condition that leaves them unable to completely close their eyes reported improvement in comfort around the eyes and overall quality of life, according to a report in the March issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals. The inability to close the eye can be a devastating result of facial paralysis. "The resulting loss of corneal protection can lead to exposure keratitis [inflammation of the cornea], corneal ulceration, and potentially permanently vision loss," the ...

New technique could help solve mystery of vanishing bees

2011-03-22

Ecologists have developed a better way of rearing bee larvae in the laboratory that could help discover why honey bee populations worldwide are declining. The technique, together with details of how statistics adapted from other areas of ecology can aid bee research, is published this week in the British Ecological Society's journal Methods in Ecology and Evolution. Human food security depends on bees because they pollinate so many of our crop plants. As a result, worldwide declines in both honey bee colonies and solitary bees are causing widespread concern. But faced ...

Combination ACE inhibitor therapy increases risk of kidney failure and death

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: