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RAAS Inhibitors May Lower Risk of Intracranial Aneurysm Rupture

Jolynn Tumolo

Renin-angiotensin-aldosterone system (RAAS) inhibitors were linked with a significant decreased rupture risk in patients with hypertension and intracranial aneurysms, according to findings from a retrospective study published in Hypertension.

“Mounting experimental evidence supports the concept that the RAAS is involved in the pathogenesis of intracranial aneurysm rupture,” researchers explained in the study background. “However, whether RAAS inhibitors could reduce the rupture risk of intracranial aneurysms remains unclear.”

To gain insight, researchers reviewed charts for 3044 patients with hypertension and intracranial aneurysms from 20 medical centers in China. Researchers looked at whether patients had experienced rupture, as well as their use of RAAS inhibitors.

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Compared with use of non-RAAS inhibitors, the use of RAAS inhibitors was significantly associated with a reduced rupture risk, according to the study. The odds ratio for rupture risk with RAAS inhibitors was 0.490.

Odds ratios for rupture risk were 0.559 with angiotensin-converting enzyme (ACE) inhibitor use and 0.414 with angiotensin receptor blocker (ARB) use compared with non-RAAS inhibitor use, researchers reported.

The association between RAAS inhibitors and reduced rupture risk occurred independent of blood pressure control, the study found.

In a secondary analysis involving 541 patients who used RAAS inhibitors matched with 541 patients who did not, prescribing RAAS inhibitors could have prevented 17.7% of ruptured aneurysms, according to study coverage in MedPage Today.

 

References

Zhong P, Lu Z, Li Z, et al. Effect of renin-angiotensin-aldosterone system inhibitors on the rupture risk among hypertensive patients with intracranial aneurysms. Hypertension. 2022;79(7):1475-1486. doi: 10.1161/HYPERTENSIONAHA.122.18970

Lou N. Can longstanding BP meds protect against brain aneurysm ruptures? MedPage Today. June 6, 2022. Accessed June 10, 2022.

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