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Angiotensin II receptor blockers and risk of acute pancreatitis - a population based case-control study in Sweden.

Abstract Acute pancreatitis is a potentially lethal disease, with a rising incidence in the Western world. Yet, no pharmacological prevention or specific treatment for acute pancreatitis exists. Also, the connection with severity of acute pancreatitis is unknown. Experimental and epidemiological research suggests a protective effect of angiotensin II receptor blockers.
PMID
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Authors

Mayor MeshTerms
Keywords

Drugs

Hypertension

Inflammation

Metabolic syndrome

Pancreas

Pharmacoepidemiology

Prevention

Risk factors

Journal Title bmc gastroenterology
Publication Year Start




PMID- 28270103
OWN - NLM
STAT- MEDLINE
DA  - 20170308
DCOM- 20170313
LR  - 20170313
IS  - 1471-230X (Electronic)
IS  - 1471-230X (Linking)
VI  - 17
IP  - 1
DP  - 2017 Mar 07
TI  - Angiotensin II receptor blockers and risk of acute pancreatitis - a population
      based case-control study in Sweden.
PG  - 36
LID - 10.1186/s12876-017-0595-8 [doi]
AB  - BACKGROUND: Acute pancreatitis is a potentially lethal disease, with a rising
      incidence in the Western world. Yet, no pharmacological prevention or specific
      treatment for acute pancreatitis exists. Also, the connection with severity of
      acute pancreatitis is unknown. Experimental and epidemiological research suggests
      a protective effect of angiotensin II receptor blockers. METHODS: During 2006 to 
      2008, we performed a nationwide case-control study on Swedish residents aged
      40-84 years. First-time cases with acute pancreatitis were identified in the
      National Patient Register and data on dispensed prescriptions was retrieved from 
      the Prescribed Drug Register. Controls were randomly selected from the general
      population in Sweden frequency-matched on sex, age, and calendar year. To
      estimate relative risk of acute pancreatitis, by degree of severity, among users 
      of angiotensin II receptor blockers, as compared to non-users, we used
      multivariable logistic regression analysis to calculate odds ratios (OR) with 95%
      confidence interval (CI). RESULTS: Among 6,161 cases of acute pancreatitis and
      61,637 controls, current use of angiotensin II receptor blockers was followed by 
      a decreased risk of acute pancreatitis, compared to non-users, adjusted OR 0 . 77
      (95% CI 0 . 69-0 . 86). No protective association, but an increased risk was
      found for users of angiotensin-converting enzyme inhibitors (adjusted OR 1 . 11, 
      95% CI: 1 . 01-1 . 21), analysed for comparison reasons. There was a significant 
      decreased risk associated with both severe acute pancreatitis, (OR 0 . 71 (0 .
      59-0 . 85), and mild acute pancreatitis; adjusted OR 0 . 81 (0 . 70-0 . 94).
      CONCLUSION: This population-based case-control study indicates that use of
      angiotensin II receptor blockers might be associated with a lesser risk of acute 
      pancreatitis, and that the protective association was significant among cases of 
      both severe and mild acute pancreatitis.
FAU - Bexelius, Tomas S
AU  - Bexelius TS
AD  - Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery,
      Karolinska Institutet, Stockholm, Sweden. tomas.s.bexelius@ki.se.
AD  - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 
      281, S-171 77, Stockholm, Sweden. tomas.s.bexelius@ki.se.
FAU - Ljung, Rickard
AU  - Ljung R
AD  - Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
FAU - Mattsson, Fredrik
AU  - Mattsson F
AD  - Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery,
      Karolinska Institutet, Stockholm, Sweden.
FAU - Lu, Yunxia
AU  - Lu Y
AD  - Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery,
      Karolinska Institutet, Stockholm, Sweden.
AD  - Program in Public Health, University of California, Irvine, CA, USA.
FAU - Lindblad, Mats
AU  - Lindblad M
AD  - Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery,
      Karolinska Institutet, Stockholm, Sweden.
AD  - Department of CLINTEC, Karolinska Institutet, Stockholm, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20170307
PL  - England
TA  - BMC Gastroenterol
JT  - BMC gastroenterology
JID - 100968547
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiotensin Receptor Antagonists/*therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Case-Control Studies
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Pancreatitis/*epidemiology/prevention & control
MH  - Risk Factors
MH  - Sweden/epidemiology
PMC - PMC5341438
OTO - NOTNLM
OT  - Drugs
OT  - Hypertension
OT  - Inflammation
OT  - Metabolic syndrome
OT  - Pancreas
OT  - Pharmacoepidemiology
OT  - Prevention
OT  - Risk factors
EDAT- 2017/03/09 06:00
MHDA- 2017/03/14 06:00
CRDT- 2017/03/09 06:00
PHST- 2016/09/02 [received]
PHST- 2017/03/01 [accepted]
AID - 10.1186/s12876-017-0595-8 [doi]
AID - 10.1186/s12876-017-0595-8 [pii]
PST - epublish
SO  - BMC Gastroenterol. 2017 Mar 7;17(1):36. doi: 10.1186/s12876-017-0595-8.

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