Abstract
In a murine model of emphysema, angiotensin receptor blockers (ARB) improved airway and airspace architecture and lung function. We hypothesized that use of ARBs and angiotensin-converting enzyme (ACE) inhibitors would be associated with higher lung function and less emphysema on computed tomography (CT).
The Multi-Ethnic Study of Atherosclerosis (MESA) recruited participants age 45-84 years free of clinical cardiovascular disease. Percent emphysema was estimated on full-inspiration cardiac CT scan using a threshold of -910 HU. Spirometry was measured following ATS/ERS guidelines. Linear regression models adjusted for age, sex, race/ethnicity, body mass index, smoking status, pack-years, exposure to second-hand smoke, educational attainment, hypertension, diabetes, asthma, family history of emphysema, statin use, female hormone replacement therapy, fish oil use and scanner type.
Among 3,599 participants (mean age 61±10 years, 51% female; 35% white, 26% black, 22% Hispanic, 16% Chinese), the proportion of participants using ARBs and ACE inhibitors was 5.5% and 11.8%, respectively. The mean square root transformed percent emphysema was 3.85±1.52, the mean FEV1(L) was 3.5±0.7. Participants using ARBs or ACE inhibitors had slightly less square root transformed percent emphysema (-0.12, 95% CI: -031, 0.07; P=0.22) and participants using ACE inhibitors had slightly higher levels of FEV1 (19 mL; 95% CI: -35, 73; P=0.50)compared to others, but neither difference was statistically significant.
In cross-sectional analysis, adjusting for various confounders, there was no evidence that use of ARB or ACE inhibitors was associated with less emphysema or better lung function.
- © 2012 ERS